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.
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.
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:
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.
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:
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.
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.
To reduce the risk of aneurysms:
People over age 65 who have ever smoked should have a screening ultrasound done once.
Braverman AC, Schermerhorn M. Diseases of the aorta. In: Libby P, Bonow RO, Mann DL, Tomaselli GF, Bhatt DL, Solomon SD eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 12th ed. Philadelphia, PA: Elsevier; 2022:chap 42.
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.
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 pubmed.ncbi.nlm.nih.gov/24957320/.
Woo EY, Damrauer SM. Abdominal aortic aneurysms: open surgical treatment. In: Sidawy AN, Perler BA, eds. Rutherford's Vascular Surgery and Endovascular Therapy. 9th ed. Philadelphia, PA: Elsevier; 2019:chap 71.BACK TO TOP
Review Date: 7/12/2021
Reviewed By: Deepak Sudheendra, MD, RPVI, FSIR, Director of DVT & Complex Venous Disease Program, Assistant Professor of Interventional Radiology & Surgery at the University of Pennsylvania Perelman School of Medicine, with an expertise in Vascular Interventional Radiology & Surgical Critical Care, Philadelphia, PA. 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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