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Abdominal artery aneurysm: Ruptured aneurysm with abdominal pain

An abdominal artery aneurysm causes a larger balloon-like bulge (dilation) in the lower part of the aorta, the largest blood vessel that supplies blood to the abdomen, pelvis and legs. The aorta runs from the heart to the center of the chest and abdomen. When an abdominal artery aneurysm ruptures or breaks open, it leads to life-threatening bleeding. Close monitoring is necessary for a small aneurysm. Treatment consists of surgery when the aneurysm is large, growing rapidly or ruptures. The prospects are less good when a large aneurysm ruptures.

  • Synonyms abdominal artery aneurysm
  • Causes: Enlarged aorta breaks open
  • Risk factors
  • Symptoms of a ruptured aneurysm: Pain in the abdomen
  • Diagnosis and examinations
  • Treatment: Waiting or surgery
  • Complications
  • Prognosis is poor when an aneurysm ruptures
  • Prevention through healthy lifestyle

 

Synonyms abdominal artery aneurysm

An abdominal artery aneurysm (AAA) is also known as an ‘abdominal aortic aneurysm’.

Causes: Enlarged aorta breaks open

It is not well known what causes an aneurysm (bulge of part of an artery). This occurs when weakness develops in the wall of the artery. In an abdominal artery aneurysm, the enlarged aorta breaks open.

Risk factors

Factors that increase the risk of an abdominal artery aneurysm include:

  • arteriosclerosis (medical term: atherosclerosis). Atherosclerosis occurs when fats and other substances build up on the lining of a blood vessel.
  • a white skin color
  • high blood pressure (hypertension)
  • an infection in the aorta
  • a trauma (such as a car accident)
  • a vascular disease in the aorta
  • genetic factors (family history)
  • male gender
  • smoking

An abdominal artery aneurysm usually occurs in men over the age of sixty. If the aneurysm is large, it breaks open or ruptures easily. This risk increases as the aneurysm enlarges. This condition is potentially life-threatening.

Symptoms of a ruptured aneurysm: Pain in the abdomen

An aneurysm develops slowly (over many years), meaning the patient is often asymptomatic. Symptoms develop quickly when the aneurysm spreads rapidly, ruptures or leaks blood into the wall of the vessel (aortic dissection).Symptoms of a ruptured aneurysm include :

  • dizziness
  • an acute abdomen (sudden severe abdominal pain)
  • clammy skin
  • low blood pressure (hypotension)
  • a shock
  • a fast heart rate (tachycardia)
  • a rapid pulse
  • pass out
  • nausea and vomiting
  • pain in the abdomen or on the side of the abdomen: The pain is deep, severe, sudden, persistent, or constant. The pain may spread to the groin, buttocks or legs.
  • back pain (pain radiating to the back)
  • to sweat

 

Diagnosis and examinations

Physical examination

The doctor examines the abdomen and notices a lump or swelling in the abdomen. The abdomen also feels stiff and a throbbing sensation can be observed near the navel. The doctor also measures the pulse in the patient’s legs.

Diagnostic research

Some imaging tests are necessary when the patient shows no symptoms or when the doctor wants to confirm the diagnosis.

  • Angiography: Radiographic image of the blood vessels (required for the operation)
  • CT scan of the abdomen (to confirm the size and location of the aneurysm)
  • Ultrasound of the abdomen (abdominal ultrasound)
  • MRI scan of the abdomen (to visualize the size and location of the aneurysm)

 

Treatment: Waiting or surgery

In the case of an aortic aneurysm, the patient requires emergency surgery. When the aneurysm is small and there are no symptoms, surgery is not always performed. However, the patient will have a check-up every six months to have the size of the aneurysm checked. If this is larger than 5.5 cm or grows quickly, surgery is required. The operation is then done before complications arise. This operation is possible using various surgical techniques.

Complications

In addition to the symptoms of a ruptured abdominal artery aneurysm, blood clots sometimes occur. When a blood clot breaks away from the inner wall of an aneurysm and blocks a blood vessel elsewhere in the body, it blocks blood flow to the legs, toes, kidneys, or abdominal organs.

Prognosis is poor when an aneurysm ruptures

The result is often good if the patient undergoes surgery before the aneurysm ruptures. When an aneurysm ruptures or ruptures, a medical emergency occurs. A large aneurysm is rare, but when it bursts it causes extensive internal bleeding that is usually fatal to the patient. Only about one in five patients survive a ruptured abdominal artery aneurysm.

Prevention through healthy lifestyle

Preventing an aneurysm is done by eating a heart-healthy diet, getting enough exercise, quitting smoking and reducing stress. Medicines also help with high blood pressure or diabetes mellitus. Male patients over the age of 65 who smoke or have another risk factor should have an abdominal ultrasound scan annually.

read more

  • Hypertension (increased blood pressure): Types and symptoms
  • Hypotension (too low blood pressure): Symptoms and treatment
  • Aneurysm: Bulge of part of an artery

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