Aneurysm

• Relatively uncommon
• found mainly in patients >70
• Usually fusiform
• Majority affect infrarenal aorta

Presentation

• Usually incidentally
  • Abdominal exam - pulsatile mass
  • AXR - calcification
  • CT - obvious aneurysm
  • USS for prostatism
• May cause backache by pressing on lumbar vertebral bodies
• May cause abdominal pain
• Embolism may lead to acutely ischaemic leg
• If symptomatic likely to be rupturing!

Rupture

• Pain
  • Acute abdomen
  • abdominal /  lumbar pain, up to 1 week duration
• Cardiovascular collapse

Categories

• True
  • dilatation of artery
  • involves all layers of vessel wall
• False
  • almost always due to trauma (if not then Marfan's syndrome)
  • Pulsating fibrous capsule around a haematoma - in direct communication with arterial lumen
  • Can occur anywhere

Types

• Aortic
• Femoral
• Popliteal
• Visceral
• Berry

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