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What are aneurysms?

What is an aneurysm?

What is the aorta?

What is an abdominal aortic aneurysm?

Why are abdominal aortic aneurysms dangerous?

 

What is an aneurysm?

An aneurysm is an abnormal, localized, blood-filled dilatation of a blood vessel. This is caused by disease, weakening or trauma to the wall of the vessel. One of the commonest sites where aneurysms occur is in the abdominal aorta.

 

What is the aorta?

When blood leaves the heart, it enters the aorta (the largest blood vessel in the body). The aorta goes all the way from the heart, through the chest and into the abdomen. At the level of the belly button it divides into 2 arteries (one for each leg). During its course, the aorta gives a number of important branches to supply the head, arms, liver, stomach, bowels and both kidneys. The normal aorta has a diameter of 1.5 to 2.5cm, depending on one's build.

 

What is an abdominal aortic aneurysm?

Aneurysms of the abdominal aorta are also called AAA (pronounced triple A). This stands for Abdominal Aortic Aneurysms. Most AAA involve the aorta below where it gives off the branches to the kidneys. In just under a quarter of cases, the aneurysm may also involve the artery on its way from the aorta to the groin. These aneurysms are known as aorto-iliac aneurysms. Less commonly the aneurysm extends upwards to involve the blood vessels (arteries) to the kidneys. These aneurysms are known as juxta-renal if they only extend up to the level of the renal (kidney) arteries, or supra-renal if they extend beyond this level.

 

Why are abdominal aortic aneurysms dangerous?

Aneurysms are like silent bombs waiting to explode. The wall of the aorta wears thin and starts to balloon out. This can be due to wear and tear but heavy smoking and fatty foods can contribute.  Until the aneurysm reaches 5cm in diameter (width), the risk of rupture is very small, but once it gets to 5.5cm the risk shoots up.

AAA are usually asymptomatic. This means that there is nothing to warn you that you have got this condition. The only warnings tend to come just before it bursts - and even then they are non-specific, such as stomach ache or back pain. When the aneurysm ruptures, you'll usually die of internal bleeding and shock within a few hours. If you can get to hospital, the survival rates are only around 50%

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Above is a CT scan from one of my patients. It shows a large abdominal aortic aneurysm that had ruptured into the vena cava. The vena cava is the largest vein in the body and runs parallel to the aorta. Whereas the aorta carries blood away from the heart the vena cava carries blood back to the heart. The patient underwent successful emergency repair. [The aneurysm is outlined in green, the normal aorta above the aneurysm in red, the vena cava in blue and the hole between the aneurysm and the cava through which the aneurysm burst is between the two yellow dots.] 

 

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Above is a CT scan of one of my patients who presented as an emergency with a ruptured aneurysm. The CT scan shows a cross-section of the patient’s abdomen. The aneurysm has been outlined in blue and the haematoma (blood leaking from the ruptured aneurysm) is outlined in red. The patient underwent successful surgical repair.