Abdominal aortic aneurysm is a life-threatening condition if not recognized and intervened quickly. It occurs when the lower, abdominal part of the aorta, which is the main artery that supplies blood to the abdomen, pelvis, legs and all other parts of the body, expands and balloons. Since the aorta is the largest vessel in the body, a ruptured or ruptured aortic aneurysm can cause serious bleeding and cause fatal complications. Since aneurysms have a sensitive and weak structure, the risk of rupture is high. Therefore, aneurysms should be recognized early and not left untreated. Depending on the size, location and growth rate of the aneurysm, there are a number of treatment protocols ranging from observation to emergency surgery. Abdominal aortic aneurysm is also known as gastric aneurysm or abdominal aneurysm.
What is Abdominal Aortic Aneurysm?
Aneurysms mean regional enlargement as a result of weakness in the artery wall. High pressure and high amount of blood inside the arteries can cause the blood vessels to expand in diameter and rupture in the future. Abdominal aortic aneurysm, that is, abdominal aortic aneurysm, describes the enlargement and ballooning of the aorta, the largest artery in the body, located in the abdomen. Aortic Aneurysms can be located anywhere along the course of the aorta. Most of it is located in the abdominal part of the aorta in the abdomen. The main factors that play a role in the development of abdominal aortic aneurysm can be listed as follows:
- Atherosclerosis (hardening of the arteries): Atherosclerosis can cause conditions such as narrowing of the vessel diameter, aneurysms behind the stenosis area, vascular occlusion and heart attack due to the accumulation of fat, cholesterol and some harmful substances and plaques in the interior of the blood vessels.
- High blood pressure level: One of the most dangerous complications of high blood pressure in the long term is that it causes weakening and damage to the aortic wall, which paves the way for the development of aneurysm.
- Vascular diseases: The main effect of vascular diseases is inflammation of the vascular walls and the resulting loss of function. Inflammation in the blood vessels is also known as vasculitis.
- Infections located in the aorta: Although it is a rare condition, some bacterial or fungal infections can settle in the aorta and cause aneurysm by damaging the vascular wall structure.
- Traumas: The incidence of abdominal aortic aneurysm is high, especially in cases such as high-energy traumas and traffic accidents inside and outside the vehicle.
- Tobacco use: Smoking is a known strong risk factor for aortic aneurysms, as well as for all aneurysms. Tobacco use causes damage and loss of structural proteins in the wall structure of the arteries, weakening the vessel wall and increasing the risk of aneurysm and rupture. The risk of developing aortic aneurysm is directly proportional to the duration and amount of smoking. Abdominal ultrasound screening is recommended for active smokers or male patients between the ages of 65 and 75 with a history of smoking.
- Age: Age is among the predisposing factors for abdominal aortic aneurysms, and the risk increases after the age of 65. Although age is a factor that cannot be changed, the way of aging can be changed and a healthy aging is possible.
- Gender: Men are more likely to have an abdominal aortic aneurysm than women.
- Family history: Having a history of abdominal aortic aneurysm, especially in a first-degree relative, increases the person’s risk of having an abdominal aortic aneurysm. It has been shown that abdominal aortic aneurysm may be genetically transmitted. Some genetic diseases affecting the connective tissue, such as Marfan Syndrome or Ehlers Danlos, tend to weaken the blood vessels and lead to aneurysms. The vessel affected is most often the abdominal aorta.
- Previous aneurysm disease or the presence of an aneurysm in another region: The presence of an aneurysm in the artery behind the knee or in the thoracic aorta, the part of the aorta in the chest, increases the risk of abdominal aortic aneurysm.
- Obesity and high cholesterol: High triglyceride levels along with high fat tissue amount and high cholesterol can lead to deterioration in the vascular structure and aneurysms.
It is important to take precautions such as lowering blood pressure and reducing the severity and progression of damage to the arteries in individuals with risk factors for aortic aneurysm.
Abdominal Aortic Aneurysm Symptoms
Abdominal aortic aneurysms usually do not cause any symptoms until they rupture. Since the symptoms of aortic aneurysm in the abdomen may not be very severe, it may lead to a delay in diagnosis. The main symptoms that can be seen are:
• Back, leg or abdominal pain that does not decrease in severity
• Pulse like a heartbeat felt in the abdomen
• Cold, pale and moist skin
• Dizziness
• Fainting and confusion
• High pulse
• Stomache ache
• Nausea and vomiting
• Shortness of breath
• There may be severe, tearing, sudden pain in the abdominal area that may extend to the waist or legs.
In case of pain that starts suddenly and is described as very severe, one should urgently seek medical attention. Main complications due to abdominal aortic aneurysm; It is a full-thickness or single-layer rupture of the aortic wall (aortic dissection) and aneurysm rupture. The larger the aneurysm and the faster its growth rate, the greater the risk of rupture and severe bleeding. Sudden, constant and intense abdominal and back pain described as a tearing sensation, low blood pressure and rapid pulse may indicate a ruptured aortic aneurysm.
How is Abdominal Aortic Aneurysm Diagnosed?
Since abdominal aortic aneurysm often does not cause symptoms, it is usually diagnosed incidentally. It is possible to diagnose abdominal aortic aneurysms that have not yet ruptured during examination and tests for different reasons. The imaging methods preferred for the diagnosis of abdominal vascular diseases and abdominal aortic aneurysm are as follows.
• Abdominal ultrasound: Ultrasound is a technique that provides fast and painless intrabody imaging using sound waves. Aortic aneurysm and rupture can often be diagnosed with abdominal ultrasound.
• 3-dimensional computed tomography angiography (CTA): If an aneurysm is seen or suspected with abdominal ultrasound, the patient may be referred for computed tomography angiography. Since computed tomography angiography is a procedure performed with contrast material, caution is recommended in cases such as renal failure. Computed tomography angiography is an effective method that helps show the exact location, size and severity of the aneurysm.
Abdominal Aortic Aneurysm Treatment
Treatment for abdominal aortic aneurysms varies depending on the location and size of the aneurysm. In aneurysms with a diameter of less than 5 centimeters, the risk of rupture is not high and urgent treatment may not be required. He was diagnosed with abdominal aortic aneurysm; However, care should be taken even in cases where follow-up is planned according to risk factors and expert evaluation. Situations that require caution can be summarized as follows:
- Having ultrasound performed at regular intervals to follow the size of the aneurysm and determine its growth rate.
- Ensuring that blood pressure is low and regular, and taking medication regularly if prescribed.
- Absolutely avoid smoking and smoking environments.
- Adopting an active lifestyle and maintaining weight control .
- Eating a healthy and regular diet and keeping cholesterol levels low to minimize the risk of atherosclerosis.
- Stay away from alcohol.
No medication, food supplement or herbal mixture can destroy an aneurysm. Therefore, the measures mentioned are applied only to prevent the growth of the abdominal aortic aneurysm and to plan abdominal aortic aneurysm surgery in those with a high risk of rupture. In the presence of symptoms suggestive of abdominal aortic aneurysm, when there is a family history of aneurysm, or in case of a previous aneurysm, it is important to consult a healthcare provider and get expert opinion.
