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Abdominal aortic aneurysm

Aneurysm - aortic; AAA

The aorta is the main blood vessel that supplies blood to the abdomen, pelvis, and legs. An abdominal aortic aneurysm occurs when an area of the aorta becomes very large or balloons out.

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Aortic rupture, chest X-ray
Aortic aneurysm

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Causes

The exact cause of an aneurysm is unknown. It occurs due to weakness in the wall of the artery. Factors that can increase your risk of having this problem include:

An abdominal aortic aneurysm is most often seen in males over age 60 who have one or more risk factors. The larger the aneurysm, the more likely it is to break open or tear. This can be life threatening.

Symptoms

Aneurysms can develop slowly over many years, often with no symptoms. Symptoms may come on quickly if the aneurysm expands rapidly, tears open or leaks blood within the wall of the vessel (aortic dissection).

Symptoms of rupture include:

Exams and Tests

Your health care provider will examine your abdomen and feel the pulses in your legs. The provider may find:

Your provider may find this problem by doing the following tests:

Any one of these tests may be done when you are having symptoms.

You may have an abdominal aortic aneurysm that is not causing any symptoms. Your provider may order an ultrasound of the abdomen to screen for an aneurysm.

Treatment

If you have bleeding inside your body from an aortic aneurysm, you will need surgery right away.

If the aneurysm is small and there are no symptoms:

Most of the time, surgery is done if the aneurysm is bigger than 2 inches (5 centimeters) across or growing quickly. The goal is to do surgery before complications develop.

There are two types of surgery:

Outlook (Prognosis)

The outcome is often good if you have surgery to repair the aneurysm before it ruptures.

When an abdominal aortic aneurysm begins to tear or ruptures, it is a medical emergency. Only about 1 in 5 people survive a ruptured abdominal aneurysm.

When to Contact a Medical Professional

Go to the emergency room or call 911 if you have pain in your belly or back that is very bad or does not go away.

Prevention

To reduce the risk of aneurysms:

People over age 65 who have ever smoked should have a screening ultrasound done once.

Related Information

High blood pressure - adults
Aneurysm
Aortic dissection
Hypovolemic shock
Arterial embolism
Heart attack
Stroke
Aortic aneurysm repair - endovascular
Abdominal aortic aneurysm repair - open
Aortic aneurysm repair - endovascular - discharge
Abdominal aortic aneurysm repair - open - discharge

References

Braverman AC. Diseases of the aorta. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 57.

Colwell CB, Fox CJ. Abdominal aortic aneurysm. In: Walls RM, Hockberger RS, Gausche-Hill M, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 76.

Fairman RM, Wang GJ. Abdominal aortic aneurysms; endovascular treatment. In: Cronenwett JL, Johnston KW, eds. Rutherford's Vascular Surgery. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 132.

LeFevre ML; U.S. Preventive Services Task Force. Screening for abdominal aortic aneurysm: U.S. Preventive Services Task Force recommendation statement. Ann Intern Med. 2014;161(4):281-290. PMID: 24957320 www.ncbi.nlm.nih.gov/pubmed/24957320.

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Review Date: 8/28/2017  

Reviewed By: Mary C. Mancini, MD, PhD, Department of Surgery, Louisiana State University Health Sciences Center-Shreveport, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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