Abdominal aorta: functions, diseases and treatments

1. What is the abdominal aorta for?

If blood can circulate throughout the body, it is precisely thanks to the aorta which is, in a way, a conduit in which blood circulates and reaches the different parts of the body. Thus, the abdominal aorta allows blood to flow through the abdomen. The role of the aorta is essential to ensure the proper functioning of the heart. The coronary arteries bring blood and oxygen to the heart. These arteries originate at the base of the aorta and fill, mainly, in diastole when the heart relaxes. The aorta is also very important for all organs of the human body. If the blood cannot circulate properly, the consequences can be relatively serious.

2. What are the diseases of the abdominal aorta?

Sometimes, the abdominal aorta can become more or less fragile. This results in dilation which can be dangerous. Indeed, the wall of the abdominal aorta becomes thinner. After a while, it may even rupture due to high blood pressure. This is called abdominal aortic aneurysm. It is the most common disease and it can affect any part of the aorta. When the aneurysm affects only part of the abdominal aorta, it is said to be a saccular aneurysm and when it affects the entire aorta, it is a fusiform aneurysm.

The peculiarity of the abdominal aortic aneurysm is that it almost never shows symptoms or at least not until it is ruptured. In case of back or abdominal pain, it means that the abdominal aorta has just ruptured. If the abdominal aortic aneurysm is not treated in time, it can lead to more or less serious consequences. Small clots can come along in the arteries and clog them in the legs, this is called thrombosis. In addition, the aneurysm can also compress nearby organs such as the small intestine, or even create infections. Therefore, as soon as you experience even minimal symptoms, you should not delay to consult a specialist so that the situation does not worsen further.

What are the different risk factors:

3. How to treat the abdominal aorta?

The abdominal aortic aneurysm is a rather complicated disease to manage since it generally does not cause any symptoms. The only abdominal or back pain related to the aneurysm occurs when there is a rupture. It is therefore very difficult to anticipate this rupture and prevent it.

Sometimes the aneurysm is detected before it ruptures, because the patient has gone to see a specialist for a completely different reason and during the examination he was supposed to take, the specialist notices the presence of the aneurysm. In addition, since 2010, a prevention campaign has been launched. It is therefore possible to be screened regularly to reduce the risk of aneurysm. These screenings can be performed by anyone, but are mainly intended for male smokers over the age of 65 who have a relative who has already had an abdominal aortic aneurysm.

In case of abdominal aortic aneurysm, there are two scenarios. If the aneurysm is small and does not present any danger, the patient will still be placed under surveillance to check the evolution of the disease. On the other hand, if the patient has abdominal or back pain caused by a rupture, in this case, one should not wait. The patient must undergo surgery urgently to avoid possible complications.

Two types of operations are possible for an abdominal aortic aneurysm:

After surgery, the main risks are thromboses, bleeding, risks of infection or even respiratory complications following the incision and pain. For the endoprosthesis, the main risk is the hematoma, or false aneurysm of the Scarpa as well as the risk of bleeding because the prosthesis is inserted, bent through the groin and as its diameter is quite large, this can cause trauma. . The patient should adopt a protein-rich diet so that convalescence is faster. Likewise, to avoid being constipated, it is recommended to drink between 7 and 9 glasses of water. In addition, after the operation, it is very important to exercise, but not too physically. Walking is ideal. In any case, you should not carry a weight of more than 5 kilos for at least 4 weeks.

If pain is felt after the operation, it is possible to take medication to calm this pain. During the hospitalization, the patient benefits from a follow-up and powerful analgesics are prescribed to calm the pain, given that the surgery subsequently causes quite significant pain. On the other hand, regardless of the type of operation chosen, the patient goes to intensive care and therefore has to stay in the hospital for a certain period of time. Once the patient is out, it is still recommended to avoid driving right away.

Complications are relatively rare. However, if in the days following the procedure, you experience fever, nausea and vomiting, redness, leg cramps or painful legs, dizziness, palpitations or chest pain, do not wait and see a doctor as soon as possible, it could be a sign of an infection or other complications. However, these complications only occur in very rare situations, but that does not mean that the risk is non-existent. This is why it is essential to carefully follow the recommendations of each specialist and to recover in the best possible conditions. In the case of abdominal surgery, the patient will have to undergo a stay in care and rehabilitation. In this way, he will be able to do respiratory physiotherapy and have cardiovascular monitoring accompanied by specific treatment.

4. Who are the doctors specializing in the abdominal aorta?

Concretely, there are two types of specialists capable of carrying out examinations of the abdominal aorta and who can possibly detect aneurysms. First, there is the radiologist. This professional specializes in medical imaging. He can intervene in various situations to take pictures that can highlight tumours, fractures or abdominal aortic aneurysms.

The second specialist is the angiologist. This professional is a specialist in vascular medicine. In other words, it is a specialist who performs tests to check the proper functioning of blood and lymphatic vessels.

It is also possible to cite the vascular surgeon who performs surgical or endovascular procedures on the patient with an abdominal aortic aneurysm. This professional works in hospitals and is able to perform surgical operations, however, not all surgeons are trained in the placement of abdominal aortic stents.

Finally, we can also mention the general practitioner who can be consulted in case of doubt or to be a little better informed on the subject. Very often, when the symptoms of abdominal aortic aneurysm occur, people are not really alarmed and therefore go to a general practitioner to find out why they have these pains. Subsequently, the doctor redirects the patients to the professionals mentioned above. Next to that, if there are symptoms of crack or rupture of aneurysm, you must directly contact the SAMU or go to the emergency room.

5. What are the medical examinations of the abdominal aorta?

To be able to make a diagnosis, the radiologist and the angiologist first perform an ultrasound of the abdomen. This technique is an echodoppler. This examination can detect the presence of an aneurysm or its absence. According to the results of this examination, if there is indeed an abdominal aortic aneurysm and the patient must be operated on, an abdominal CT scan must be performed. In this way, the specialist will be able to visualize in more detail the importance of the aneurysm and determine what type of material he will need, in what size... Sometimes, the specialist can create tailor-made endoprostheses before the operation, d 'where the importance of this review.

Apart from this, another complementary examination is carried out. This is a preoperative assessment. In this assessment, the patient must pass an abdominal CT scan and an arteriography. This examination is relatively important, because on the one hand, it allows to check the pulmonary function and the cardiac function, but in addition to that, it allows to detect the presence of possible other aneurysms. In 25% of cases, when the patient has an abdominal aortic aneurysm, he also has an aneurysm in the popliteal arteries (knees) or femoral arteries (legs). Finally, a consultation with the anesthesiologist is also to be carried out.

Sources:

CHUV: abdominal aortic aneurysm

Health passport: focus on the abdominal aortic aneurysm

Le Figaro health: the aorta

Also read:

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⋙ All you need to know about a ruptured aneurysm

⋙ Soon a blood test to prevent aneurysm rupture?