Abdominal aortic aneurysm is an aneurysmal dilatation of the abdominal aorta, usually defined as an aneurysm whose diameter increases by more than 50%. Abdominal aortic aneurysms are predominant in elderly males, with a male-to-female ratio of 10:3. Smoking significantly increases the risk of aneurysm rupture. Most abdominal aortic aneurysms are lesions below the renal artery level. Common causes include atherosclerosis, and other rare causes include cystic degeneration of the middle layer of the artery, syphilis, congenital dysplasia, trauma, infection, connective tissue disease, etc. Common risk factors for abdominal aortic aneurysm include smoking, hypertension, old age, male, etc. Most patients are asymptomatic and are often found by chance by physical examination for other reasons. A typical abdominal aortic aneurysm is an expansive mass pulsating laterally and anteroposterior. Half of the patients are accompanied by vascular murmurs. A few patients have symptoms of compression. Abdominal fullness is not common. Symptomatic abdominal aortic aneurysms often indicate the need for surgical treatment. The main symptoms include:
For the common symptoms before rupture, mostly located around the umbilical cord and mid-upper abdomen. When an aneurysm invades the lumbar spine, there may be lumbosacral pain. If severe abdominal or lumbar pain occurs recently, it often indicates that the aneurysm is on the verge of rupture.
Patients with acute rupture manifested sudden severe pain in the back, accompanied by shock, and even died before admission. If it breaks into the retroperitoneum, the hemorrhage is limited to form hematoma. Abdominal pain and hemorrhagic shock can last for hours or days, but the hematoma often breaks into the peritoneal cavity again and causes death. The aneurysm may also break into the inferior vena cava, resulting in aortic venous fistula and heart failure. Occasionally, tumors can break into the duodenum and cause massive gastrointestinal bleeding.
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