Overview
An abdominal aortic aneurysm (AAA) is a bulging or ballooning in the wall of the abdominal aorta — the main blood vessel that carries blood from the heart to the lower part of the body. Over time, the aneurysm can enlarge, and if it ruptures, it can cause life-threatening bleeding. Many AAAs grow slowly without symptoms, making early detection challenging.
Symptoms
Most AAAs are asymptomatic and are often found incidentally during imaging for other conditions. When symptoms do appear, they may include:
A pulsating feeling near the navel Deep, constant abdominal pain Back pain Sudden severe pain in the abdomen or back (possible sign of rupture) Low blood pressure and fainting (in rupture cases)
Causes
The exact cause is not always clear, but factors that weaken the aortic wall contribute, including:
Atherosclerosis (plaque build-up in arteries) High blood pressure Smoking Genetic conditions (e.g., Marfan syndrome, Ehlers-Danlos syndrome) Infections (rarely) Trauma to the abdomen
Diagnosis
Diagnosis often occurs through imaging tests such as:
Ultrasound – the most common and non-invasive screening tool CT scan – provides detailed images and sizing for surgical planning MRI – useful for detailed imaging in certain cases Physical exam – sometimes a doctor can feel a pulsating mass
Treatment
Treatment depends on the aneurysm’s size, growth rate, and symptoms:
Monitoring (watchful waiting) – for small, slow-growing AAAs (regular ultrasound/CT checks) Lifestyle changes – controlling blood pressure, quitting smoking, healthy diet Surgery : Open abdominal surgery – replacing the affected aorta section with a synthetic graft Endovascular aneurysm repair (EVAR) – minimally invasive graft placement inside the aorta
Complications
If untreated, an AAA can lead to serious complications:
Rupture – life-threatening internal bleeding Blood clots – can cause embolism in legs or other organs Compression of nearby structures – causing pain or digestive problems Shock and death – from massive blood loss in rupture cases
Prevention
While not all AAAs can be prevented, risk can be reduced by:
Quitting smoking Controlling blood pressure and cholesterol Eating a balanced diet low in saturated fat Exercising regularly Screening in at-risk individuals (men over 65, smokers, those with family history)