DILATED LOCALISED SEGMENT OF ARTERIAL SYSTEM /ANEURYSM

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                               ANEURYSM 

INTRODUCTION:

  • It is a dilatation of localized segment of arterial system .
  • true aneurysm -contains all three layers of artery 
  • false aneurysm -contains single layer of fibrous tissue wall of sac and it usually occurs after trauma

Sites: 

  • Aorta
  • Femoral
  • Popliteal
  • Subclavian


Berry aneurysm -multiple aneurysm occurring in circle of Willis

Abdominal aneurysm commonest aortic aneurysm

Peripheral aneurysm less common compared to cavity aneurysm 



Types:

  • Fusiform
  • Saccular
  • Dissecting 








Etiology :

  • Atherosclerosis (to learn  Etiology of atherosclerosis ) 
  • Syphillis
  • Traumatic 
  • Collagen disease like Marfan syndrome
  • Dissecting aneurysm -hypertension 
  • Trauma
  • Cystic medial necrosis 





CLINICAL FEATURES:

Swelling -pulsatile,

Smooth,

Soft,

Warm, 

Palpitation-thrill,

Auscultation -bruit 

Altered sensation due to compression of nerve 

Erosion into bone, joints, trachea 

aneurysm and thrombus form embolus results in gangrene of toes, digits .







DIFFERENTIAL DIAGNOSIS:

  • Pyogenic abscess
  • vascular tumor 
  • AV fistula 
  • Pulsating Tumor-sarcoma ,pulsating secondary's 

INVESTIGATION :

  • Angiogram
  • Doppler study 
  • Test for relevant cause - blood ,sugar 





TREATMENT :

  • Reconstruction of artery using arterial graft 
  • Arterial endoaneury 
  • Therapeutic embolization 

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