ANEURYSM

DEFINITION:-

An aneurism is a distension of an artery brought about a weakening destruction of arterial wall. (A balloon-like swelling in the wall of an artery.)

CAUSES:-

  • Smoking
  • Local infection
  • Congenital weakness of vessels
  • Syphilis
  • Trauma
  • Degenerative disease.


PATHOPHYSIOLOGY:-

    Due to congenital defects or artherosclerosis
    ↓
    Degenrative changes (Media layer)
    ↓
    Loss of elasticity/ Weakness or dilation


TYPES:-

It is of two types:

  1. True Aneurysm: In a true aneurysm, layers of vessl wall dilate in one of following ways:
    • Saccular (A unilateral outpouching)
    • Fusiform (A bilateral outpoching)
    • Dissecting (outpouching with separate layers)

  2. False Aneurysm (Pseudoaneurysm): In false aneurysm, the wall rupture, and a blood clot is retained in an outpouching of tissue.


SIGNS AND SYMPTOMS:-

In abdominal aortic aneurysm (AAAs)

  • Abdominal pain with intense back and flank pain.
  • Abdominal pain without pulsating mass
  • Pulsating abdominal mass
  • Shock
  • Hypotension
  • Tachycardia
  • Decreased cardiac output.


COMPLICATIONS:-

  • MI ischemia
  • Stroke
  • Lower extremities ischemia
  • Paraplegia.


SURGICAL MANAGEMENT:-

  • Surgical management of an aneurysm may be perfomed as an emergency or an elective procedure.
  • Surgical technique involves exposure of aneurysm, application of clamps just above and below and exclusion of aneurysm and replacement of excised segment with a Dacron graft.

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