Gen Surg: aorta - AAA

Question 2

Define abdominal aortic aneurysm

Answer 2

Dilatation of the abdominal aorta greater than 3cm

Question 3

Where are most AAAs situated?

Answer 3

Below the renal arteries - infrarenal.

Question 4

Thinking of the tunica layers in arteries, what is AAA usually due to?

Answer 4

Degeneration of the tunica media - specifically the elastin and collagen.

Question 5

How do AAA present?

Answer 5

Asymptomatic. PMH of atherosclerosis, trauma, infection, connective tissue disease, inflammatory disease. Pulsatile mass felt in the abdomen above the umbilicus.

Question 6

How do ruptured AAA present?

Answer 6

Persistent abdo AND back pain. Dizzy, syncopal, LOC, SOB, shock. Sudden CVS collapse

Question 7

How are AAAs investigated?

Answer 7

Screening programme in 65th year for men. US confirms Dx, CT with contrast is then done to check surrounding anatomy and to plan for elective surgery.

Question 8

What advice can you give someone who has AAA?

Answer 8

Improve BP control, smoking cessation, exercise, weight loss, statins and aspirin therapy

Question 9

Who would be suitable to have AAA surgery?

Answer 9

If AAA is 5.5cm1cm/year or if symptomatic

Question 10

What surgical treatments are available for AAA?

Answer 10

Open repair or endovascular repair (keyhole).