Aneurysm is the expansion of the vessel, more than twice its normal diameter. More than 60% of all aneurysms are located in the abdominal aorta. This pathology occurs more often in people suffering from rheumatism, aortoarteritis, syphilis, atherosclerosis, and tuberculosis. A common cause of aneurysm is abdominal trauma, aortic surgery.
Mechanism of occurrence
The occurrence of expansion is associated with degenerative changes in the elastic frame of the aorta. With increasing resistance in the distal arteries, the pressure in the abdominal aorta rises. In the absence of the vessel's ability to withstand increased pressure, its expansion occurs in a particular place. Aneurysm - a section of the aorta with a turbulent flow of blood, in which blood clots often form.
Clinic
With a small diameter of the aneurysm (less than 20% of cases), an asymptomatic course is possible. In other cases, all clinical signs of aneurysm are divided into typical and indirect. Typical: a pulsating abdominal mass, pain, noise during a contraction of the heart over an aneurysm. The pain may resemble hepatic or renal colic, localized to the left of the navel, and may radiate to the back or lower back.
Indirect signs
- Abdominal syndrome: nausea, vomiting, lack of appetite, weight loss.
- Urological syndrome: hematuria, dysuric disorders.
- Sciatica syndrome: lower back pain, motor and sensory disorders in the legs.
- Chronic leg ischemia syndrome: intermittent claudication, trophic changes.
Aneurysm is a constantly progressing disease. More than half of patients die within 2 years after diagnosis of complications.
Diagnostics
Ultrasound examination allows you to establish the localization and size of the formation. On the monitor, an aneurysm is a roundish expansion of the vessel with clear contours, parietal overlays and slowed down turbulent blood flow. Angiography reveals aortic enlargement. On the panoramic x-ray picture of the abdominal organs , the expanded contours of the aorta with deposition of calcifications are visible, often accompanied by impressions on the vertebrae - usury. With CT, a rounded formation with clear contours, thin walls, parietal thrombi and calcifications is determined.
Treatment
Aneurysm is a disease in which, in the vast majority of cases, surgery is performed, which is associated with a high probability of developing complications. The operation is contraindicated in patients who have had acute myocardial infarction, have a history of circulatory failure, stroke.
Surgical intervention
There are various options for surgical treatment:
- removal of aneurysm with aneurysmal sac, prosthetic aorta or bypass surgery;
- removal of aneurysm without a bag with intra-bag prosthetics.
Prosthetics are often accompanied by aortic femoral prosthetics. Mortality after an intervention does not exceed 10%. At high risk of surgery, aortic stenting is performed: a self-healing prosthesis is inserted through the femoral artery .
Complicated Aneurysm
The consequences of the aneurysm directly depend on its size: the larger it is, the greater the likelihood of its stratification or rupture.