Vascular pathology. Aneurysms of the abdominal aorta

The aorta is called the main largest artery of the body. It performs the connective function between the heart and the internal organs.

Aneurysms are pathological extensions that most often appear in the aorta. They appear in the weakened, weakened sections of the vessel. High blood pressure promotes enlargement. Later diagnosis of the disease can lead to rupture of the vessel and fatal bleeding. In addition, the expansion contributes to the violation of blood flow, which, in turn, increases the risk of blood clot (thrombosis). The blood clot can spread along the vascular passage, while its fragmented elements can move with the bloodstream. Thus, embolism occurs. Excess calcium deposits also form on the thin wall of the vascular wall.

Extensions can be formed at any vascular site. Aneurysms of the abdominal aorta are observed in three out of four cases of all aortic aneurysms. The shape of the resulting expansion can be sack-shaped or fusiform.

The development of an aneurysm of the abdominal aorta can be a consequence of atherosclerosis, arterial hypertension, inflammatory processes in the walls of the vessel. The formation of extensions can be associated with congenital connective tissue diseases, as well as infectious diseases accompanied by damage to the aortic wall.

Symptoms of an aneurysm of the abdominal aorta are manifested by strong sudden painful sensations in the lumbar region and abdomen. Manifestations of the disease are also accompanied by sensations of pulsating formations in the abdominal part. At the same time, their rhythm coincides with the rhythm of the heart rate. Rarely there is pain in the legs, accompanied by their pallor and "cyanosis", which is caused by the migration of pieces of the thrombus along the arterial highways.

The rupture of the aneurysm of the abdominal aorta is accompanied by bleeding. The symptomatology in this case depends on the direction of the rupture.

With intraperitoneal breakthrough of the aneurysm of the abdominal aorta, a hemorrhagic shock occurs accompanied by an increase in internal bleeding. In addition, there is a sharp blanching of the skin, a quickening of the pulse. Percussion of the abdomen reveals the presence of free fluid in the abdominal cavity. The catastrophic course of the disease in this case completely excludes any research. Death comes quickly enough.

A retroperitoneal rupture is accompanied by pain in the lower back or abdomen.

The breakthrough of the aneurysm of the abdominal aorta into the inferior vena cava is characterized by shortness of breath, weakness, palpitations. In this case, there are pains in the waist and abdomen with a pulsating formation in it and a characteristic systolic-diastolic noise (hum). These manifestations are characterized by systematic, but inexorable progression. As a result, heart failure occurs in severe form.

The expansion gap toward the duodenum is accompanied by a sudden collapse and bloody vomiting.

A patient's examination in a horizontal position often reveals an increased aneurysm ripple. Palpation (palpation) of the upper half of the abdomen (more often on the left side of its central line) reveals the presence of a pulsating tumor-like formation. As a rule, it is motionless, can be painless or painless. When auscultation (listening), a systolic rumble over the formation is revealed. Small extensions can be detected using computed tomography.

As a rule, the use of general clinical instrumental research methods allows to correctly diagnose the disease in the majority of patients. That is why the purpose of aortography is necessary only in cases when the results of the studies do not show a clear picture of the disease.

Given the suddenness of manifestations of complications, treatment of an aneurysm of the abdominal aorta is carried out by an operative method. This removes and replaces the affected vessel.