Aortic aneurysm

Overview aortic aneurysm (bifurcated graft) means partial aortic wall or diffuse abnormal expansion oppression of the surrounding organs and cause symptoms, tumor-like main risk for rupture. Etiology normal artery wall full of middle elastic fiber, with every stroke for systolic and diastolic blood and transmission. Damage to the middle and elastic fiber breakage and replaced by fibrous scar tissue, arterial wall loses flexibility and is unable to flow impact tolerance, artery lesions of gradually enlarged, and the formation of aneurysms. Intra-arterial pressure increased to aneurysm formation. The main cause of aortic aneurysms main reasons are as follows : (1) Atherosclerosis is the most common reason. Aortic wall plaque erosion, the destruction of the middle composition, elastic fiber degeneration occurred. The wall of atherosclerosis and thickening, trophoblast vascular pressure, nutrition obstacles occur, or trophoblast vascular rupture and blood in the middle. More common in elderly men, the sex ratio of 10 : 1%. In the main part of the abdominal aorta, especially in the renal artery to the origin of the fork between the iliac. (2) of syphilis infection in a significant erosion of regular thoracic aorta. Sepsis, endocarditis bacteremia so that the bacteria reach the blood flow through the aorta, and aortic directly adjacent to the abscess spread or atherosclerotic ulcer on the basis of secondary infection, the bacteria can form aneurysms. Pathogens to Streptococcus, Staphylococcus aureus and Salmonella is mainly rare. (3) cystic necrosis middle of a relatively rare cause for the disease. Aortic elastic fibers of the middle and replaced with acid-mucopolysaccharide. Mainly observed in the ascending aortic aneurysm, men see more. Genetic diseases such as Marfan syndrome, Turner (Turner) syndrome. Egypt - When the (Ehlers-Danlos) syndrome may have cystic necrosis middle. Prone to cause dissection. (4) traumatic penetrating wound direct role in the damage caused Department aortic aneurysm, can occur at any site. Indirect injury violence often difficult role in moving parts .. subclavian artery origin of the distal or ascending aortic root. Mobile is not easy and the location, by the Department of more easily aneurysm. (5) a congenital aortic sinus tumor-based. (6) Other including cytomegalovirus aortic Yan, Behcet's disease, rheumatoid aorta occur. Pathological changes in the structure by aortic aneurysms can be divided into : ① true aortic aneurysm : aneurysm sac from the arterial wall layer or multilayer structure; ② false aneurysm : trauma, infection, and other reasons blood from the artery to artery overflow surrounding tissue, blood clots and machine compounds, fibrous tissue and arterial wall together constitute the aneurysm wall. ③ dissection. Endarterectomy or middle torn, blood brought gradually into the middle dissection, the separation cavity blood, swelling, and the artery can also pose a double cavity structure (Figure 3). By aortic aneurysm morphology can be divided into : ① saccular aneurysm : artery aneurysm involved the perimeter part of cystic and have neck, Spirogyrate asymmetry. ② fusiform aneurysm : artery aneurysm involved the entire perimeter. Traumatic appearing saccular aneurysm, atherosclerosis appearing spindle. By location, aortic aneurysms can be divided into : ① ascending aortic aneurysm, often involving aortic aneurysm; ② aortic arch aneurysm; ③ descending thoracic aortic aneurysms or thoracic aortic aneurysm, starting in left subclavian artery distal; ④ abdominal aortic aneurysm, often in the distal renal artery. Aortic sinus involved in the proximal ascending aortic aneurysm often congenital, followed by Marfan syndrome, syphilis and infection; ascending aortic aneurysm by atherosclerosis, the middle cystic necrosis, syphilitic; descending thoracic aortic aneurysm, abdominal aortic aneurysm to atherosclerosis as the main reason. Aortic aneurysm mostly single, a handful of two or more. With the course of development, aortic aneurysms can occur; ① rupture : Aneurysm weak wall of the aneurysm by the constant flow shocks gradually enlarged, and finally broke through and caused bleeding. ② mural thrombus formation : tumor cord blood slowly forming eddy current, as in the inside wall of the aneurysm rough and easy to be thrombosis, thrombus embolization to be peeled off. ③ secondary infections : secondary infection wall of the aneurysm is more so weak and easy to break. Sometimes aneurysm repeatedly to a small bleeding around the tumor accumulation of a great deal of the surrounding fibrous tissue, cyst formation, so it may play a protective role to avoid rupture. Figure 3 aortic dissection type Map clinical symptoms of aortic aneurysm is a tumor from oppression, traction, Erosion caused by the surrounding tissue, depending on the aortic aneurysm size and location determined. Thoracic aortic aneurysm pressure on the inferior vena cava with his face, neck and shoulder venous engorgement and may have edema; trachea and bronchial compression caused coughing and short breath; oppression esophageal dysphagia; recurrent laryngeal nerve compression caused hoarseness. Thoracic aortic aneurysm in the ascending aorta may deformed aortic valve, isolation valve page where aortic insufficiency, Because of the noise, most of the slow process, the fewer symptoms if there can be sharp to acute pulmonary edema. Thoracic aortic aneurysms often caused pain, the pain suddenly rupture may presage intensified. Aortic arch aneurysm compression of the left innominate vein, the left upper extremity than can right upper limb venous pressure high. Ascending aortic aneurysm could erode the sternum and cartilage in the chest and abdomen, was pulsatile mass; descending aortic aneurysm can be eroded thoracic vertebra and rib, and even in the back surface of Spirogyrate; Bone involvement throughout all have pain. Thoracic aortic aneurysms rupture into the bronchi, trachea, pleural or pericardial can be lethal. Common abdominal aortic aneurysm can be asymptomatic, because the cause to atherosclerosis mainly, it often kidney, brain, Coronary Atherosclerosis symptoms. Initially draw attention to is a pulsatile abdominal mass. The more common symptoms of abdominal pain, usually located in the periomphalic enterocelia or upper abdomen, it may relate back, Pain in the development and shows aneurysm or a small amount of bleeding increased. Continued intense pain to the back, pelvis, perineum and leg extension, or on the mass marked tenderness. are signs of rupture. Abdominal aortic aneurysms often broken into the left retroperitoneal space, followed by income abdomen, may even break into the inferior vena cava or the duodenum, After the rupture occurred often shock. Unless the problem of obesity, pulsatile mass in general it is not difficult to lay hands on, usually in the navel to the pubic symphysis, sometimes in mass Department systolic murmur can be heard, with a few also tremor. For aortic aneurysm lay hands on weekends, especially when tenderness and care must be taken to prevent rupture prompted. Abdominal aortic aneurysms oppression iliac vein can cause lower extremity edema, oppression spermatic vein partially visible varicose veins, oppression side ureter to hydronephrosis, pyelonephritis and renal dysfunction.