LETS KNOW ABOUT ABDOMINAL AORTIC ANEURYSM

ABDOMINAL AORTIC ANEURYSM (AAA)

AAAs are present in 5% of men aged over 60 years and 80% are confined to the infrarenal segment. 

1. COMMON PRESENTATIONS OF AAA :

A. INCIDENTAL

On physical examination, plain x-ray or, most commonly, abdominal ultrasound

B. PAIN

In the central abdomen, back, loin, iliac fossa or groin

 C. THROMBOEMBOLIC COMPLICATIONS 

Thrombus within the aneurysm sac may be a source of emboli to the lower limbs

D. COMPRESSION

Surrounding structures such as the duodenum ( obstruction and vomiting ) and the inferior vena cava ( oedema and deep vein thrombosis )

 E. RUPTURE

Into the retroperitoneum, the peritoneal cavity or surrounding structures ( most commonly the inferior vena cava, leading to an aortocaval fistula )

2. MANAGEMENT

Until an asymptomatic AAA has reached a maximum of 5.5 cm in diameter, the risks of surgery generally outweigh the risks of rupture. 

3. POPULATION SCREENING AND PREVENTION OF RUPTURED AAA

"Ultrasound screening for AAA in men aged 65-75 years, with surgical repair of those AAAs that are bigger than 5.5 cm, are rapidly growing or become symptomatic, reduces the community incidence of rupture by approximately 50% and is cost-effective. "

Open AAA repair has been the treatment of choice in both the elective and the emergency settings, and entails replacing the aneurysmal segment with a prosthetic ( usually Dacron ) graft.

In the UK, a national screening programme for men over 65 years of age has been introduced using ultrasound scanning.