AUTUMN DEW
In daily life, the body may experience notable cases, the arterial system gradually becomes sclerotic, plaques appear in the lumen causing narrowing or weakening of the vessel wall, forming an aneurysm. The most dangerous is the abdominal aortic aneurysm, when it ruptures, the patient faces a very high risk of death but does not know that he has the disease if not screened. Recently, doctors at Can Tho General Hospital have continuously saved many cases of abdominal aortic aneurysm, a life-threatening risk.
Dr. Truong Dinh Hung examines a patient after surgery. Photo provided by the hospital
Ms. TTB (71 years old, in Vinh Thanh district, Can Tho city) has just been discharged from the hospital after a near-death experience due to the risk of rupture of an abdominal aortic aneurysm. On June 8, 2023, she went to Can Tho General Hospital for a medical examination because of dull abdominal pain in the epigastric region and around the navel. She also suffered from high blood pressure and dyslipidemia. Through examination and abdominal ultrasound and CT scan results, the doctor diagnosed the patient with an abdominal aortic aneurysm below the kidney, 45mm in diameter, 7cm long, and ulcerated blood vessel wall. The doctors consulted and indicated surgery to replace the abdominal aortic aneurysm with an artificial blood vessel graft. The surgery was successful, and the patient was discharged from the hospital in stable health.
In mid-May 2023, a 62-year-old male patient in Thoi Lai district was also admitted to Can Tho General Hospital with a dull abdominal pain around the navel, which did not improve with pain medication. Through examination, abdominal ultrasound and CT scan, the doctor discovered that the patient had an abdominal aortic aneurysm below the kidney with the largest diameter of 50mm and a length of about 19cm. For this patient, the doctors consulted and prescribed surgery to replace the abdominal aortic aneurysm with an artificial blood vessel graft. During the surgery, the surgeon noted that inside the aneurysm there was an old blood clot attached to the wall and an infected plaque. The surgery was successful, the patient recovered well after surgery and was discharged from the hospital.
According to Dr. Truong Dinh Hung, Department of Thoracic and Vascular Surgery, Can Tho General Hospital, the abdominal aorta supplies blood to the organs in the abdomen and the lower half of the body. The diameter of an abdominal aortic aneurysm increases by at least 50% compared to normal. In Vietnamese people, an abdominal aorta with a diameter of 30-35mm or more is called an aortic aneurysm. Each year, an estimated 200,000 people worldwide die from ruptured aortic aneurysms in the lower part of the kidney.
Abdominal aortic aneurysm has many causes, of which atherosclerosis accounts for more than 95% of cases. There are also a number of other, less common causes such as congenital damage, genetics, infection or trauma, after surgery. People over 60 years old are at high risk of abdominal aortic aneurysm. Men are 4 times more likely to have abdominal aortic aneurysm than women. The disease also has a genetic factor, with about 20-29% of relatives of patients with abdominal aortic aneurysm being found to have this disease. In addition, lifestyle factors such as smoking, hypertension and metabolic disorders of sugar and blood lipids are also at risk.
According to medical specialists, most abdominal aortic aneurysms have no symptoms. Among the complications, the most dangerous is the rupture of the abdominal aortic aneurysm. If it ruptures in the abdomen, the patient immediately has abdominal pain, back pain, low blood pressure, and rapid heart rate. Most patients die before reaching a medical facility. Patients who are still alive when they reach the hospital also have a very high mortality rate. Another complication is distal embolism due to blood clots or atherosclerotic material breaking off and blocking the renal arteries, intestines, and lower limbs.
Most abdominal aortic aneurysms are diagnosed incidentally during clinical examination or abdominal ultrasound. Other diagnostic methods include computed tomography or MRI. In treatment, medical monitoring is applied to cases of small fusiform aneurysms, less than 4cm in size, with serious accompanying diseases, surgical difficulties or patients refusing surgery. Most patients with large aneurysms at risk of rupture will undergo surgery to replace the abdominal aortic aneurysm with an artificial vascular graft. In addition, doctors can also apply endovascular intervention to treat this disease, however, the cost is very high.
In recent times, the Department of Thoracic and Vascular Surgery of Can Tho General Hospital has received, treated and successfully operated on many cases of abdominal aortic aneurysms below the kidneys. Many cases had large aneurysms or were threatened with rupture, or had ruptured. Doctors mainly replaced the aneurysm with artificial blood vessel grafts for patients, achieving high treatment efficiency and quick recovery. Dr. Pham Van Phuong, Deputy Director of the Hospital, said that in the coming time, the Hospital will continue to improve the capacity of the team to develop surgeries to treat diseases, trauma cases, and aortic wounds. At the same time, it will coordinate with endovascular intervention to treat aortic diseases.
Doctors recommend that patients with risk factors for aortic aneurysm and patients with abdominal aortic aneurysm but not yet indicated for surgery or intervention should have regular check-ups and monitoring for early detection, timely surgery or intervention, and minimize the risk of aortic aneurysm rupture.
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