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Abdominal aortic aneurysm: Treatment, symptoms, advice and help

About abdominal aortic aneurysm

Abdominal aortic aneurysm is a disorder of the aorta, the main artery from the heart. As the name suggests, a section of aorta in the abdominal area bulges out due to weakness in the vessel wall.

Abdominal aortic aneurysm: Incidence, age and sex

Abdominal aortic aneurysm is most commonly seen in people who are over 60 years of age. There is a significant male preponderance.

Signs and symptoms of abdominal aortic aneurysm: Diagnosis

Abdominal aortic aneurysm is a silent disorder in most patients and is usually not diagnosed until it has markedly increased in size. Occasionally the patient might complain of mild pain in the belly or lower back. In most cases, it is an accidental diagnosis either during physical examination which can reveal a pulsating mass near the navel, or during some imaging investigations like ultrasound, or a CT scan.

Causes and prevention of abdominal aortic aneurysm

The Aorta is a major blood vessel which carries blood from the heart to various organs of the body. Deposits of cholesterol and fatty material in the arterial wall causes atherosclerosis which results in damage to the aorta and causes it to lose its flexibility. Certain risk factors like diabetes, high blood pressure, high blood cholesterol, obesity and smoking augment atherosclerosis which precedes an aortic aneurysm. The presence of an aortic aneurysm in a family member is a potential risk factor.

This aneurysm or bulging of the vessel wall can arise anywhere in the aorta, from chest to belly. Most commonly it occurs near the navel.

It is best to incorporate lifestyle modifications to reduce the risk of an abdominal aortic aneurysm. Here are some tips which can help in the prevention of an abdominal aortic aneurysm:

  • Regular physical exercise to trim down excess weight.
  • Appropriate dietary habits not only to shed excess weight but also reduce blood cholesterol and lipids.
  • Cessation of smoking.
  • Keeping blood pressure under control with adequate treatment.
  • Regular screening with ultrasonography if there is positive family history of aortic aneurysm.

Abdominal aortic aneurysm: Complications

The most alarming complication of an abdominal aortic aneurysm is its rupture leading to heavy bleeding inside the abdomen. The chances of rupture are increased with growth in size of the aneurysm. Rupture is suspected when one encounters sudden, sharp pain in the lower abdomen especially in a patient with a history of aortic aneurysm. The pain is accompanied by sweating, breathlessness, palpitations, nausea and vomiting. This is a medical emergency and the patient needs to be rushed to hospital immediately. The patient can go into shock if not managed timely.

Abdominal aortic aneurysm: Treatment

The treatment of an aortic aneurysm includes both non-surgical and surgical modalities. The non-surgical modalities include lifestyle modifications which help in curbing the potential risk factors. Such lifestyle modifications not only help in preventing the increase in the size of the aneurysm but also diminish the risk of its rupture. Regular monitoring of the aortic diameter is recommended to prevent recurrence of a rupture.

Surgical treatment may be considered only when the size of the aneurysm exceeds 5 cm as this signifies impending rupture, and has to be surgically managed. Aneurysm can be managed either by a major surgical procedure in which a part of the affected vessel wall is replaced with an artificial graft. Alternatively, ‘endovascular surgery’, which is minimally invasive, can also be considered . It is done through an artery in the leg which joins the aorta in the abdomen. A stent graft is passed through a leg artery and then into the aorta where it will get replaced with the affected portion.

The decision of surgery can be taken only after a discussion between the doctor and the patient where the pros and cons are explained to the patient.