Abdominal Aortic Aneurysm (AAA)
Splenic artery Aneurysm General Surgery Free Questions
Age - 60 years
Sex - Male
Who are at risk - Smokers, Hypertension
Specific Questions - Associated with Ehler Danlos and MArfan Syndrome - So common in families
Most commons for abdominal aortic Aneurysm
Most common location - Infra renal (MCQ)
Most common Cause - Atherosclerosis
Most common complication - Rupture
Most common Size and Shape - Fusiform and more than 3 cm
At what size are the chances of rupture>? 5 - 5.5 cm
What is the growth rate of AAA - 0.2 -03. cm/year
What is the most common presentation - Asymptomatic, If symptomatic then back pain
What is the most common finding - Expansile pulsation
Most common complication after surgery - Renal Insufficiency
Surgery and Management
Do not give muscle relaxant. It diminishes the tamponade effect
Surgery is excision with Aorto bifemoral graft
Indications for surgery for Abdominal Aortic Aneurysm
(a) Aneurysm > 5.5 cm in largest diameter
(b) Increase in diameter of more than 1cm per year
(c) Symptomatic aneurysm – back pain, tenderness on palpation, distal embolism, ruptured/leaking aneurysm
Complications of Surgery for Aortic aneurysm
Early
1. Acute myocardial infarction –
2. Stroke (due to hypotension or embolism)
3. Renal insufficiency
4. Colon ischaemia – occurs in 2-6%
5. Trash foot – embolism of thrombus from the aneurysm
6. Infection of graft
7. Spinal cord ischaemia (quite uncommon)
8. Haemorrhage
Late
1. Aortoenteric fisula – frank PR bleeding, torrential
2. Late infection of prosthetic graft material
3. Sexual dysfunction