Aortic Aneurysm of the Abdomen

An aortic aneurysm of the abdomen is an abnormal bulge in the wall of the aorta, the body's main artery. It generally occurs where this big artery branches to carry blood to the legs. Such aneurysms are four times more common in men than in women and most prevalent between ages 50 and 80.

Over half of all people with untreated abdominal aneurysms die, primarily from a rupture of the bulge, within 2 years of diagnosis. About 15% survive beyond 5 years.

What Causes it?

About 95% of aortic aneurysms of the abdomen result from arteriosclerosis (hardening of the arteries). These aneurysms develop slowly. Blood pressure within the aorta progressively weakens the vessel walls and enlarges the aneurysm.

What are its Symptoms?

Although aortic aneurysms of the abdomen usually don't cause symptoms, most are evident (unless the person is obese) as a pulsating mass near the naval. Sometimes it's tender.

Lower back pain that radiates to the side and groin from pressure on lumbar nerves may signifY that the aneurysm has grown and is about to rupture.

Aortic Aneurysm of the Abdomen

Rupture of an aneurysm may cause severe, persistent abdominal and back pain. Twenty percent of people whose aneurysms rupture die immediately. In some cases, signs of hemorrhage - such as weakness, sweating, a fast pulse, and low blood pressure - may be subtle. People with a rupture may remain in stable condition for hours before going into shock.

How is it Diagnosed?

Because an aortic aneurysm of the abdomen rarely produces symptoms, it's often detected accidentally on an X-ray or during a routine physical exam. An ultrasound test can determine aneurysm size, shape, and location. Aortography (X-rays of the aorta after injection of a dye) shows the condition of vessels in the region of the aneurysm and the extent of the aneurysm.

How is it Treated?

Usually, aortic aneurysm of the abdomen requires surgical removal of the aneurysm and replacement of the damaged aortic section with a Dacron graft. If the aneurysm is small and produces no symptoms, surgery may be delayed; however, small aneurysms may also rupture. Regular physical exams and ultrasound checks are necessary to detect enlargement, which may forewarn of rupture. Large aneurysms or those that produce symptoms involve a significant risk of rupture and need immediate surgical repair.