Skip to main content
SpringerLink
Log in

AAA and Visceral Aneurysms

  • Chapter
  • First Online:
CT Scan in Abdominal Emergency Surgery

Part of the book series: Hot Topics in Acute Care Surgery and Trauma ((HTACST))

  • 1011 Accesses

Abstract

An aneurysm is a section of artery which is dilated in comparison to its original vessel diameter. By definition this is generally accepted as dilatation by at least one and a half times the normal vessel diameter. Therefore aneurysms are defined by the artery affected rather than by absolute diameters. Aneurysms can be classified as either true or false. True aneurysms are those which are bound by all three layers of the artery (intima, media, and adventitia), whereas false aneurysms, also known as pseudoaneurysms, are bound only by adventitia. As an aneurysm enlarges, the risk of rupture increases, but for any given size, pseudoaneurysms have a relatively higher rupture risk when compared to true aneurysms of the same size.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Ouriel K, Green RM, Donayre C, et al. An evaluation of new methods of expressing aortic aneurysm size: relationship to rupture. J Vasc Surg. 1992;15:12–8.

    Article  CAS  PubMed  Google Scholar 

  2. Forsdahl SH, Singh K, Solberg S, Jacobsen BK. Risk factors for abdominal aortic aneurysms: a 7-year prospective study: the Tromsø Study, 1994–2001. Circulation. 2009;119:2202–8.

    Article  PubMed  Google Scholar 

  3. Landenhed M, Engström G, Gottsäter A, et al. Risk profiles for aortic dissection and ruptured or surgically treated aneurysms: a prospective cohort study. J Am Heart Assoc. 2015;4:e001513. doi:10.1161/JAHA.114.001513.

    Article  PubMed  PubMed Central  Google Scholar 

  4. The UK Small Aneurysm Trial Participants. Mortality results for randomized controlled trial of early elective surgery or ultrasonographic surveillance for small abdominal aortic aneurysms. Lancet. 1998;352:1649–55.

    Article  Google Scholar 

  5. Brewster DC, Cronenwett JL, Hallett JW Jr, et al. Guidelines for the treatment of abdominal aortic aneurysms. Report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery. J Vasc Surg. 2003;37:1106–17.

    Article  PubMed  Google Scholar 

  6. Scott SWM, Batchelder AJ, Kirkbride D, Naylor AR, Thompson JP. Late survival in nonoperated patients with infrarenal abdominal aortic aneurysm. Eur J Vasc Endovasc Surg. 2016;52(4):444–9.

    Article  CAS  PubMed  Google Scholar 

  7. Darling RC III, Brewster DC, Darling RC, LaMuraglia GM, Moncure AC, Cambria RP, et al. Are familial abdominal aortic aneurysms different? J Vasc Surg. 1989;10:39–43.

    Article  PubMed  Google Scholar 

  8. ACC/AHA. 2005 Practice Guidelines for the management of patients with peripheral arterial disease (lower extremity, renal, mesenteric, and abdominal aortic): a collaborative report from the American Association for Vascular Surgery/Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, and the ACC/AHA Task Force on Practice Guidelines (Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease): endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation; National Heart, Lung, and Blood Institute; Society for Vascular Nursing; TransAtlantic Inter-Society Consensus; and Vascular Disease Foundation. Hirsch AT, Haskal ZJ, Hertzer NR, Bakal CW, Creager MA, Halperin JL, Hiratzka LF, Murphy WR, Olin JW, Puschett JB, Rosenfield KA, Sacks D, Stanley JC, Taylor LM Jr, White CJ, White J, White RA, Antman EM, Smith SC Jr, Adams CD, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Hunt SA, Jacobs AK, Nishimura R, Ornato JP, Page RL, Riegel B, American Association for Vascular Surgery, Society for Vascular Surgery, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, Society of Interventional Radiology, ACC/AHA Task Force on Practice Guidelines Writing Committee to Develop Guidelines for the Management of Patients With Peripheral Arterial Disease, American Association of Cardiovascular and Pulmonary Rehabilitation, National Heart, Lung, and Blood Institute, Society for Vascular Nursing, TransAtlantic Inter-Society Consensus, Vascular Disease Foundation Circulation. 2006; 113(11):e463–654.

    Google Scholar 

  9. Mealy K, Salman A. The true incidence of ruptured abdominal aortic aneurysms. Eur J Vasc Surg. 1988;2:405–8.

    Article  CAS  PubMed  Google Scholar 

  10. Johansen K, Kohler TR, Nicholls SC, et al. Ruptured abdominal aortic aneurysm: the Harborview experience. J Vasc Surg. 1991;13:240–5. discussion 245–7

    Article  CAS  PubMed  Google Scholar 

  11. Heikkinen M, Salenius J, Zeitlin R, et al. The fate of AAA patients referred electively to vascular surgical unit. Scand J Surg. 2002;91:345–52.

    Article  CAS  PubMed  Google Scholar 

  12. Dueck AD, Kucey DS, Johnston KW, Alter D, Laupacis A. Survival after ruptured abdominal aortic aneurysm: effect of patient, surgeon, and hospital factors. J Vasc Surg. 2004;39:1253–60. [PubMed]

    Article  PubMed  Google Scholar 

  13. Heikkinen M, Salenius JP, Auvinen O. Ruptured abdominal aortic aneurysm in a well-defined geographic area. J Vasc Surg. 2002;36:291–6.

    Article  CAS  PubMed  Google Scholar 

  14. Starnes BW, Quiroga E, Hutter C, Tran NT, Hatsukami T, Meissner M, et al. Management of ruptured abdominal aortic aneurysm in the endovascular era. J Vasc Surg. 2010;51:9–17. discussion: 18

    Article  PubMed  Google Scholar 

  15. Johnson PT, Fishman EK. IV contrast selection for MDCT:current thoughts and practice. Am J Roentgenol. 2006;186(2):406–15.

    Article  Google Scholar 

  16. Siegel CL, Cohan RH, Korobkin M, Alpern MB, Courneya DL, Leder RA. Abdominal aortic aneurysm morphology: CT features in patients with ruptured and nonruptured aneurysms. Am J Roentgenol. 1994;163:1123–9.

    Article  CAS  Google Scholar 

  17. Schwartz SA, Taljanovic MS, Smyth S, O’Brien MJ, Rogers LF. CT findings of rupture, impending rupture, and contained rupture of abdominal aortic aneurysms. Am J Roentgenol. 2007;188:W57–62.

    Article  Google Scholar 

  18. Wadgaonkar AD, Black JH, Weihe EK, Zimmerman SL, Fishman EK, Johnson PT. Abdominal aortic aneurysms revisited: MDCT with multiplanar reconstructions for identifying indicators of instability in the pre- and postoperative patient. Radiographics. 2015;35(1):254–68. doi:10.1148/rg.351130137.

    Article  PubMed  Google Scholar 

  19. Mehard W, Heiken J, Sicard G. High-attenuating crescent in abdominal aortic aneurysm wall at CT: a sign of acute or impending rupture. Radiology. 1994;192(2):359–62.

    Article  CAS  PubMed  Google Scholar 

  20. Halliday KE, Al-Kutoubi A. Draped aorta: CT sign of contained leak of aortic aneurysms. Radiology. 1996;199:41–3.

    Article  CAS  PubMed  Google Scholar 

  21. Huang YK, Hsieh HC, Tsai FC, et al. Visceral artery aneurysm: risk factor analysis and therapeutic opinion. Eur J Vasc Endovasc Surg. 2007;33:293–301.

    Article  PubMed  Google Scholar 

  22. Carr SC, Pearce WH, Vogelzang RL, McCarthy WJ, Nemcek AA Jr, Yao JST. Current management of visceral artery aneurysms. Surgery. 1996;120(4):627–34. doi:10.1016/s0039-6060(96)80009-2.

    Article  PubMed  CAS  Google Scholar 

  23. Berceli SA. Hepatic and splenic artery aneurysms. Semin Vasc Surg. 2005;18(4):196–201.

    Article  PubMed  Google Scholar 

  24. Abbas MA, Stone WM, Fowl RJ, et al. Splenic artery aneurysms: two decades experience at Mayo clinic. Ann Vasc Surg. 2002;16:442–9.

    Article  PubMed  Google Scholar 

  25. O’Arend P, Douillez V. Hepatic artery aneurysm: case report. Acta Chir Belg. 2007;107(4):409–11.

    Article  Google Scholar 

  26. Abbas MA, Fowl RJ, Stone WM, Panneton JM, Oldenburg WA, Bower TC, et al. Hepatic artery aneurysm: factors that predict complications. J Vasc Surg. 2003;38:41–5.

    Article  PubMed  Google Scholar 

  27. Nathan DP, Wang GJ, Woo EY, Fairman RM, Jackson BM. Open and endovascular repair of hepatic artery aneurysm: two case reports and review of the literature. Vascular. 2011;19:42–6.

    Article  PubMed  Google Scholar 

  28. Vultaggio F, Morère P-H, Constantin C, Christodoulou M, Roulin D. Gastrointestinal bleeding and obstructive jaundice: Think of hepatic artery aneurysm. World J Gastrointest Surg. 2016;8(6):467–71.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Henke PK, Cardneua JD, Welling TH, et al. Renal artery aneurysms: a 35-year clinical experience with 252 aneurysms in 168 patients. Ann Surg. 2001;234:454–62. discussion 462–3

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  30. Reiher L, Grabitz K, Sandmann W. Reconstruction for renal artery aneurysm and its effect on hypertension. Eur J Vasc Endovasc Surg. 2000;20:454–6.

    Article  CAS  PubMed  Google Scholar 

  31. Cohen JR, Shamash FS. Ruptured renal artery aneurysms during pregnancy. J Vasc Surg. 1986;6:51–9.

    Article  Google Scholar 

  32. Connell JM. Han DC Celiac artery aneurysms: a case report and review of the literature. Am Surg. 2006;72(8):746–9.

    PubMed  Google Scholar 

  33. Stone WM, Abbas M, Cherry KJ, et al. Superior mesenteric artery aneurysms: Is presence an indication for intervention? J Vasc Surg. 2002;36:234–7.

    Article  CAS  PubMed  Google Scholar 

  34. Sun J, Li DL, Wu ZH, He YY, Zhu QQ, Zhang HK. Morphologic findings and management strategy of spontaneous isolated dissection of the celiac artery. J Vasc Surg. 2016;64(2):389–94.

    Article  PubMed  Google Scholar 

  35. Corey MR, Ergul EA, Cambria RP, English SJ, Patel VI, Lancaster RT, Kwolek CJ, Conrad MF. The natural history of splanchnic artery aneurysms and outcomes after operative intervention. J Vasc Surg. 2016;63(4):949–57.

    Article  PubMed  Google Scholar 

  36. Lorelli DR, Cambria RA, Seabrook GR, Towne JB. Diagnosis and management of aneurysms involving the superior mesenteric artery and its branches: a report of four cases. Vasc Endovasc Surg. 2003;37(1):59–66.

    Article  Google Scholar 

  37. Kordzadeh A, Watson J, Panayiotopolous YP. Mycotic aneurysm of the superior and inferior mesenteric artery. J Vasc Surg. 2016;63(6):1638–46.

    Article  PubMed  Google Scholar 

  38. Moore E, Matthews MR, Minion DJ, et al. Surgical management of peripancreatic arterial aneurysms. J Vasc Surg. 2004;40(2):247–53.

    Article  PubMed  Google Scholar 

  39. Vu KN, Kaitoukov Y, Morin-Roy F, Kauffmann C, Giroux MF, Thérasse E, Soulez G, Tang A. Rupture signs on computed tomography, treatment, and outcome of abdominal aortic aneurysms. Insights Imaging. 2014;5(3):281–93.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

A special thanks to associate professor An Tang (University of Montreal) for allowing us to use his previously published illustrative images (Figs. 16.3, 16.4, 16.5, 16.6, 16.7, and 16.8) [39].

Author information

Authors and Affiliations

  1. Interventional Radiology Fellow, Auckland City Hospital, Auckland, New Zealand

    Jaap Ottevanger

  2. Interventional Radiologist, Auckland City Hospital, Auckland, New Zealand

    Stephen Merrilees

  3. Auckland City Hospital, Auckland, New Zealand

    Ian Civil (Professor of Surgery, Vascular Surgeon)

Authors
  1. Jaap Ottevanger
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen Merrilees
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Ian Civil
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ian Civil .

Editor information

Editors and Affiliations

  1. Emergency and Trauma Surgery, Ospedale Maggiore di Parma Emergency and Trauma Surgery, Parma, Parma, Italy

    Fausto Catena

  2. Cambridge Colorectal Unit, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke’s Hospital, Cambridge, United Kingdom

    Salomone Di Saverio

  3. General, Emergency and Trauma Surgery, Department Bufalini Hospital, Cesena, Italy

    Luca Ansaloni

  4. General, Emergency and Trauma Surgery Department, Bufalini Hospital, Cesena, Italy

    Federico Coccolini

  5. Department of Surgery, Macerata Hospital, Macerata, Italy

    Massimo Sartelli

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG, part of Springer Nature

About this chapter

Cite this chapter

Ottevanger, J., Merrilees, S., Civil, I. (2018). AAA and Visceral Aneurysms. In: Catena, F., Di Saverio, S., Ansaloni, L., Coccolini, F., Sartelli, M. (eds) CT Scan in Abdominal Emergency Surgery. Hot Topics in Acute Care Surgery and Trauma. Springer, Cham. https://doi.org/10.1007/978-3-319-48347-4_16

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-48347-4_16

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-48346-7

  • Online ISBN: 978-3-319-48347-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation