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Pathology - Abdominal aortic aneurysm
Definition
A permanent dilatation of the abdominal aorta exceeding 3 cm in diameter.
Epidemiology
The incidence is stated to be 5–10%.
Aetiology
Nearly all are attributable to aortic atherosclerosis.
Mechanism of disease development
Proteolytic enzymes compromise the aortic medium, resulting in aneurysmal alterations. Elevated concentrations of matrix metalloproteinases have been identified in aneurysmal aortas. These enzymes are recognized for their ability to breakdown elastin.
Pathology
Unruptured aneurysms are frequently asymptomatic; nonetheless, they may induce abdomen or back pain. Most are identified inadvertently during abdominal examination or imaging. Ruptured abdominal aortic aneurysms manifest as a surgical emergency characterized by abdominal discomfort and shock.
Macroscopy
The aorta exhibits dilation, typically occurring behind the renal arteries. Extensive atherosclerosis is consistently observed, frequently accompanied by secondary thrombosis and calcification.
Prognosis: The natural progression is characterized by gradual expansion. The risk of rupture is exponentially correlated with diameter. • Mortality following rupture surpasses 80%. Elective surgical intervention is recommended for aneurysms with a maximal diameter of 5.5 cm or greater.
Definition
A permanent dilatation of the abdominal aorta exceeding 3 cm in diameter.
Epidemiology
The incidence is stated to be 5–10%.
Aetiology
Nearly all are attributable to aortic atherosclerosis.
Mechanism of disease development
Proteolytic enzymes compromise the aortic medium, resulting in aneurysmal alterations. Elevated concentrations of matrix metalloproteinases have been identified in aneurysmal aortas. These enzymes are recognized for their ability to breakdown elastin.
Pathology
Unruptured aneurysms are frequently asymptomatic; nonetheless, they may induce abdomen or back pain. Most are identified inadvertently during abdominal examination or imaging. Ruptured abdominal aortic aneurysms manifest as a surgical emergency characterized by abdominal discomfort and shock.
Macroscopy
The aorta exhibits dilation, typically occurring behind the renal arteries. Extensive atherosclerosis is consistently observed, frequently accompanied by secondary thrombosis and calcification.
Prognosis: The natural progression is characterized by gradual expansion. The risk of rupture is exponentially correlated with diameter. • Mortality following rupture surpasses 80%. Elective surgical intervention is recommended for aneurysms with a maximal diameter of 5.5 cm or greater.
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