Abdominal Aortic Aneurysm: Difference between revisions
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== Prevalence == | == Prevalence == | ||
Abdominal aortic aneurysms account for three fourths of all aortic aneurysms, and have been reported to occur four times as often as a thoracic aortic aneurysm | Abdominal aortic aneurysms account for three fourths of all aortic aneurysms, and have been reported to occur four times as often as a thoracic aortic aneurysm.<ref name="Merck" /><ref name="Differential">Goodman CC, Snyder TEK. Differential diagnosis for physical therapists: screening for referral. St. Louis, MO: Saunders/Elsevier; 2013.</ref> Occurrence of this condition is reported as 0.5-3.2% of the general population according to the Merck Manual ranging from 1.0-14.2% in men, and 0.2-6.4% in women.<ref name="Merck" /><ref name="Li">Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and Trends of the Abdominal Aortic Aneurysms Epidemic in General Population - A Meta-Analysis. Plos ONE [serial on the Internet]. (2013, Dec), [cited March 24, 2016]; 8(12): 1-11. Available from: Academic Search Complete.</ref> This study found geographic differences, Australia having the highest incidence, followed by America, Europe, and Asia.<ref name="Li" /> AAA’s are much more common in men, occurring up to four to six times more often in men.<ref name="Merck" /><ref name="Aggarwal">Aggarwal S, Qamar A, Sharma V, Sharma A. Abdominal aortic aneurysm: A comprehensive review. Experimental And Clinical Cardiology [serial on the Internet]. (2011, 2011 Spring), [cited March 24, 2016]; 16(1): 11-15. Available from: MEDLINE.</ref> The most typical location of an AAA is below the renal arteries (80%), although they may also occur lower, involving the iliac arteries.<ref name="Merck" /><ref name="Differential" /><ref name="Aggarwal" /> A majority of AAA’s are fusiform, though some are saccular.<ref name="Merck" /> AAA’s are reported to be the 14th leading cause of death in the United States, causing 4500 deaths directly, with an additional 1400 deaths as a result of complications during surgical repair to prevent rupture.<ref name="Aggarwal" /> It is also reported that over 45,000 surgeries are performed each year in an effort to prevent the rupture of an AAA.<ref name="Aggarwal" /><br> | ||
== Characteristics/Clinical Presentation == | == Characteristics/Clinical Presentation == | ||
Revision as of 21:49, 5 April 2016
Original Editors - Justin Rosinski and Clint Morris from Bellarmine University's Pathophysiology of Complex Patient Problems project.
Top Contributors - Clinton Morris, Justin Rosinski, Elaine Lonnemann, Evan Thomas, Kim Jackson, Lucinda hampton, Admin, WikiSysop and David Olukayode
Definition/Description[edit | edit source]
An aneurysm is defined as an increase in the diameter of a vessel compared to normal segments by 50% or more.[1] This occurs as a result of localized weakening of the arterial wall, and must include all 3 layers (intima, media, and adventitia) of the arterial wall to be considered a true aneurysm.[1] Aneurysms are most common in the aorta, particularly the abdominal and thoracic regions, but may also affect any part of the vascular system, including lesser arteries and veins.[2]
Aneurysms are typically defined as fusiform or saccular, with fusiform aneurysm defined as a widening in the circumference of the artery in a localized area and saccular aneurysm as a localized herniation of the arterial wall.[1] A dissecting aneurysm may also develop, and is similar to a fusiform aneurysm in that it is a bilateral enlargement of arterial wall, except that there is separation of the layers of the artery.[2] A pseudoaneurysm is defined as a leaking of blood from the arterial lumen into connective tissue, contained outside of the arterial wall.[1]
Although an aneurysm may occur in any artery, they are most common in the abdominal and thoracic regions.[1] The abdominal aorta begins at the aortic hiatus in the diaphragm (approximately T12 vertebral level), and ends at approximately the L4 vertebral level, where it splits into the right and left common iliac arteries.[3] The abdominal aorta is approximately 13 cm in length.[3] In the abdominal aorta, the most common location of an AAA is just below the renal arteries.[1] The most common complications arising from an abdominal aortic aneurysm (AAA) include pain from ischemia, thromboembolism, spontaneous dissection, and rupture of the aneurysm leading to hemorrhage and possible death.[1]
Prevalence[edit | edit source]
Abdominal aortic aneurysms account for three fourths of all aortic aneurysms, and have been reported to occur four times as often as a thoracic aortic aneurysm.[1][4] Occurrence of this condition is reported as 0.5-3.2% of the general population according to the Merck Manual ranging from 1.0-14.2% in men, and 0.2-6.4% in women.[1][5] This study found geographic differences, Australia having the highest incidence, followed by America, Europe, and Asia.[5] AAA’s are much more common in men, occurring up to four to six times more often in men.[1][6] The most typical location of an AAA is below the renal arteries (80%), although they may also occur lower, involving the iliac arteries.[1][4][6] A majority of AAA’s are fusiform, though some are saccular.[1] AAA’s are reported to be the 14th leading cause of death in the United States, causing 4500 deaths directly, with an additional 1400 deaths as a result of complications during surgical repair to prevent rupture.[6] It is also reported that over 45,000 surgeries are performed each year in an effort to prevent the rupture of an AAA.[6]
Characteristics/Clinical Presentation[edit | edit source]
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Associated Co-morbidities[edit | edit source]
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Medications[edit | edit source]
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Diagnostic Tests/Lab Tests/Lab Values[edit | edit source]
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Etiology/Causes[edit | edit source]
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Systemic Involvement[edit | edit source]
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Medical Management (current best evidence)[edit | edit source]
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Physical Therapy Management (current best evidence)[edit | edit source]
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Differential Diagnosis[edit | edit source]
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Case Reports[edit | edit source]
-Mechelli F, Preboski Z, Boissonnault W. Differential Diagnosis of a Patient Referred to Physical Therapy With Low Back Pain: Abdominal Aortic Aneurysm. J Orthop Sports Phys Ther. 2008;38(9):551-557.
-Rodeghero J, Denninger T, Ross M. Abdominal Pain in Physical Therapy Practice: 3 Patient Cases. J Orthop Sports Phys Ther. 2013;43(2):44-53.
-Kim N, Kang S, Park S. Coexistence of expanding abdominal aortic aneurysm and aggravated intervertebral disc extrusion -a case report-. Korean Journal of Anesthesiology. 2013;65(4):345.
-Baskaran D, Ashraf N, Ahmad A, Menon J. Inflammatory abdominal aortic aneurysm: a persistent painful hip. Case Reports. 2013;2013(sep13 1):bcr2013009150-bcr2013009150.
-Kawatani Y, Nakamura Y, Hayashi Y, Taneichi T, Ito Y, Kurobe H et al. A Case Report on the Successful Treatment ofStreptococcus pneumoniae-Induced Infectious Abdominal Aortic Aneurysm Initially Presenting with Meningitis. Case Reports in Surgery. 2015;2015:1-6.
Resources
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Recent Related Research (from Pubmed)[edit | edit source]
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References[edit | edit source]
- ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 Porter RS, Kaplan JL. The Merck manual of diagnosis and therapy. Whitehouse Station, NJ: Merck Sharp &amp;amp;amp;amp;amp;amp; Dohme Corp.; 2011.
- ↑ 2.0 2.1 Goodman CC, Fuller KS. Pathology: implications for the physical therapist. St. Louis, MO: Saunders/Elsevier; 2009.
- ↑ 3.0 3.1 Moore KL, Agur AMR, Dalley AF, Moore KL. Essential clinical anatomy. Baltimore, MD: Lippincott Williams &amp;amp;amp;amp;amp; Wilkins; 2015.
- ↑ 4.0 4.1 Goodman CC, Snyder TEK. Differential diagnosis for physical therapists: screening for referral. St. Louis, MO: Saunders/Elsevier; 2013.
- ↑ 5.0 5.1 Li X, Zhao G, Zhang J, Duan Z, Xin S. Prevalence and Trends of the Abdominal Aortic Aneurysms Epidemic in General Population - A Meta-Analysis. Plos ONE [serial on the Internet]. (2013, Dec), [cited March 24, 2016]; 8(12): 1-11. Available from: Academic Search Complete.
- ↑ 6.0 6.1 6.2 6.3 Aggarwal S, Qamar A, Sharma V, Sharma A. Abdominal aortic aneurysm: A comprehensive review. Experimental And Clinical Cardiology [serial on the Internet]. (2011, 2011 Spring), [cited March 24, 2016]; 16(1): 11-15. Available from: MEDLINE.
