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An aneurysm can form almost anywhere, and the symptoms and possible complications depend on it. Aneurysm of the abdominal aorta is registered in 0,5 – 3,2% of the population. Many live for years and are unaware of the presence of this disease until complications develop. But forewarned is forearmed.
What is aortic aneurysm
An aneurysm is a bulge in the wall of an artery. The aorta is the largest of them, and can withstand a lot of pressure, but if its walls weaken, then a lot of pressure causes the weakened area to protrude. And if it occurs in the abdominal region, then it is called an aneurysm of the abdominal aorta.
The abdominal part of the aorta passes through the trunk and branches into 2 parts, which supply blood to the lower extremities. An aneurysm of the abdominal aorta in adults forms just before this separation.
In clinical practice, it is customary to distinguish several types of abdominal aortic aneurysms:
Small – up to 4,4 cm in diameter. There are no symptoms, and the risk of rupture is minimal. However, continued medical supervision is recommended to prevent and control aneurysm growth.
average – from 4,5 to 5,4 cm. This is a more complex formation that requires close monitoring, and with a tendency to increase, the issue of an operation is decided. After all, the larger the aneurysm, the higher the chance of its rupture.
Large – more than 5,5 cm. And in this case, the probability of rupture is the highest.
Causes of abdominal aortic aneurysm in adults
Increasing pressure and weakening of the aortic wall is the main cause of an abdominal aortic aneurysm. This pressure can build up due to atherosclerosis, when plaque builds up on the vessel wall. The share of aneurysms that have developed due to atherosclerotic lesions account for 96% of cases.
In the mechanism of development of aneurysm, hereditary diseases play a role, for example, Marfan syndrome, Ehlers-Danlos syndrome. Injuries, the action of infectious processes, for example, due to syphilis, tuberculosis, are not excluded.
Another possible reason is an allergic-inflammatory process, for example, due to nonspecific aortoarteritis. In addition to the reasons, risk factors can also be distinguished:
- age 60 – 65 years and older;
- male gender;
- hypertonic disease;
- smoking;
- hereditary predisposition;
- hypercholesterolemia.
Symptoms of an abdominal aortic aneurysm in adults
In most cases, there are no symptoms of an abdominal aortic aneurysm and the diagnosis is random. But if the aneurysm increases in size, signs may appear: heaviness and bursting, pain in the left side of the abdomen.
An aortic rupture is characterized by a sharp pain in the abdomen, which can radiate to the lower back, perineum. Weakness increases, loss of consciousness is possible. Rupture of an aneurysm of the abdominal aorta in adults is a critical condition that poses a threat to human life. And you need immediate medical attention.
Diagnostics
Due to the absence of symptoms, the diagnosis is often made by chance. But when symptoms appear, the main methods of examination are reduced to visualization of the abdominal aorta:
- Ultrasound – helps determine the size of the aneurysm;
- CT – gives a three-dimensional picture of the aneurysm, allows you to study it in more detail and estimate the size;
- angiography – assessment of the state of blood vessels using CT and MRI with the introduction of a contrast agent.
Even in the absence of symptoms, all people aged 65 to 75 years (especially men) are recommended to be tested for an abdominal aortic aneurysm.
Treatment of an aneurysm of the abdominal aorta in adults
Small adult abdominal aortic aneurysms usually do not require treatment, but need careful monitoring and monitoring. Expectant management involves following doctor’s recommendations and lifestyle changes. One of the main ones is the rejection of bad habits, nutrition correction and weight control. And control examinations at the vascular surgeon are carried out twice a year.
If an aneurysm of the abdominal aorta in adults is more than 5 cm, then the question arises of surgical treatment. The indication for its implementation is an increase in its size by more than 1 cm per year. But the decision is made individually, based on the patient’s condition and potential risks.
Treatment can be carried out by open resection of the aneurysm, followed by aortic prosthesis: under general anesthesia, the aneurysm is removed and the vessel site is replaced with a synthetic prosthesis. This treatment is aimed at preventing complications that threaten the life of the patient. Such operations are associated with some health risks, but in general, the prognosis of the operation is good.
Modern treatments
Aortic aneurysm arthroplasty is an alternative to abdominal surgery. Its implementation does not require general anesthesia, and is carried out through small punctures in the groin area. Through them, catheters are inserted, delivering the endoprosthesis to the dilated vessel. This mesh frame “turns off” the aneurysm from the bloodstream, making it almost impossible for it to rupture.
Recovery and rehabilitation after surgery takes less than a week, but requires constant monitoring and supervision by a doctor.
Prevention of abdominal aortic aneurysm in adults at home
Unfortunately, it is not always possible to prevent the development of an abdominal aortic aneurysm in adults. After all, age and genetic predisposition are uncontrollable risk factors. Nevertheless, some recommendations will help reduce the risks of its formation and complications:
- healthy and active lifestyle;
- adherence to the rules of healthy eating and a balanced diet;
- giving up bad habits: smoking, alcohol abuse;
- maintaining normal weight.
Popular questions and answers
Abdominal aortic aneurysm is a potentially fatal condition, which is why it is so important to identify it, manage it, and predict complications in a timely manner. He told us about possible complications, alarming symptoms and treatment features general practitioner, endocrinologist, cardiologist Alexey Zhito.
Thrombosed aortic aneurysm. In the aneurysm, the blood flow is sharply disturbed, which creates conditions for thrombosis and this is a life-threatening condition. Thrombi from the aneurysm can “fly away” further along the bloodstream – into the vessels of the small pelvis, arteries of the lower extremities and cause an acute circulatory arrest, which can result, for example, in amputation of the leg. If the aneurysm is located above the outlet of the renal arteries from the aorta, then blood clots can also enter the renal arteries, and this can lead to acute circulatory disorders in the kidney – its infarction.
Pronounced pain syndrome. If an aneurysm breaks down with dissection of its walls, the nerve endings in it will signal pain. The level of pain can be extremely severe and can be confused with acute appendicitis, gallstone disease, pancreatitis, and renal colic.
Compression Syndrome. If the aneurysm is large enough, it can begin to compress nearby organs and lead to completely different consequences and symptoms, for example, the ureter can be compressed and urine outflow is disturbed, in men, the veins that drain blood from the testicles and scrotum can be compressed and their swelling is possible.
Pulsation in the abdomen. If the aneurysm is large enough, then with each contraction of the heart, a pulse wave will be transmitted to the aneurysm, and it will pulsate. The patient will visually see a pulsation in the abdomen.
The main symptoms that may require emergency medical attention:
● pain in the abdomen, lower back, back (signs of impending rupture and dissection of the aneurysm);
● sharp pains and discoloration of one of the legs (possible signs of thrombosis of the artery of the lower limb);
● impurities of blood in the urine (this can be a kidney infarction);
● a sharp decrease in blood pressure, pallor of the skin, weakness, loss of consciousness (possible signs of aneurysm rupture and internal bleeding).
On the contrary, it is extremely important to listen to the recommendations of your doctor on the use of drugs to lower blood pressure (for patients with hypertension), cholesterol (for patients with dyslipidemia), normalize blood sugar levels (for patients with diabetes mellitus), quit smoking ( active and passive) and compliance with the schedule of examinations (for example, abdominal ultrasound).