Abdominal Aortic Aneurysm: Causes, Symptoms, Diagnosis, Treatment and Prevention

An abdominal aortic aneurysm is said to have occurred, when the large blood vessel that carries blood away from the heart and supplies to the abdomen, pelvis and legs, dilates or bulges. This localised dilatation of the abdominal aorta exceeds the normal diameter by more than 50 percent. Aneurysms also occur in other areas of the aorta, but the abdomen is the most common site.

The majority of the abdominal aortic aneurysms reported are the ones that occur below the kidneys (infrarenally), although they can also occur at the level of the kidneys(pararenally) or above the kidneys (suprarenally). Males are five times more likely than females to be affected by this and occurs most commonly in individuals aged between 65 and 75.

Symptoms

Aneurysms take time to develop slowly over many years, often have little or no symptoms. If the aneurysm expands rapidly, it tears open or blood leakage happens along the wall of the vessel, and symptoms develop suddenly. Upon the expansion of the aneurysm, they may become painful and leads to pulsating sensations in the abdomen or pain in the chest, lower back, or scrotum.  Some of the common symptoms for abdominal aortic aneurysm are:

  • Back pain or abdominal pain – which is sudden, severe and persistent and the pain may radiate to the groin, buttocks, or legs.
  • Clammy skin
  • Vomitting
  • Rapid heart rate
  • Shock 

Causes

Risk factors for developing and aortic aneurysm are:

  • Smoking – above 90% of people who develop the aneurysm have smoked.
  • Male gender – aneurysm occurs often in males over 60 with one or more risk factors.
  • Genetic factors – high familial prevalence rate in male individuals.
  • Other causes – several other risk factors include obesity, high blood pressure and cholestrol, infection, trauma, arteritis, cystic medial necrosis.

When the abdominal aortic aneurysm ruptures, it is a bonafide medical emergency. Complications that arise from the aneurysm include:

  • Arterial embolism
  • Heart attack
  • Hypovolemic shock
  • Kidney failure
  • Stroke

Diagnosis & Treatment

The aneurysm is usually diagnosed through a physical exam, ultrasound, or CT scan. Ultrasonography is used to screen for aneurysms and determine it’s size, also aiding the detection of peritoneal fluid. It is noninvasive and sensitive, but the presence of bowel gas may limit it’s usefulness. Less often used methods for visualization of the aneurysm include MRI and angiography.

Upon detecting the aneurysm, if it is a small dilatation and not expanding quickly, then it is usually left alone and watched for changes in size by ultrasound examination of the abdomen every six months. Patients should call their doctor in the case of abdominal tenderness or back pain as these may be signs of an impending rupture.

Surgery is recommended for patients suffering from abdominal aortic aneurysms that are bigger than 5.5 cm across and growing quickly. The two approaches to surgery are:

  • Open Repair – This is the traditional method where a large cut is made in the patient’s abdomen and the abnormal vessels are substituted with a man-made graft material, for e.g, Dacron.
  • Endovascualar Stent Grafting – The advantage of this procedure is that it can be done without the large cut in the patient’s abdomen, thus enabling a faster heal. Endovascualr repair may not be the solution for a leaking or bleeding aneurysm.

Prevention

In order to reduce the risk of developing this aneurysm some changes in your life-style is very important. For starters, remember to eat a diet that is healthy for your heart, stop smoking and also follow a low-stress life-style.

Individuals who belong to the demography with maximum occurance of this aneurysm, i.e, males over the age of 65 who have ever smoked should get screened by an ultrasound scan at least once.