Aneurysm


Different types of arterial aneurysms (scheme): 1 - true; 2 - grasevina; 3 - a false; 4 - dissecting.

Aneurysm - extension of the arterial lumen due to the stretching and protrusion of its walls (true aneurysm) by either filled with blood cavities lying in tissues outside of the artery, but communicating with her through the hole in the wall (false aneurysm) (Fig.). True aneurysm - a cylindrical or saccular form, develops mainly in atherosclerosis of vessels, most of the aorta (see aortic Aneurysm); sometimes (in the brain) may be congenital. In rare cases developed the so-called dissecting aneurysm (which in the thickness of the walls of the vessel is formed cavity, soamsawali with the vessel lumen) and grasevina aneurysm. The last form of the aneurysm is a bulging of the inner lining artery through a defect in the muscle and her outer shells. False aneurysm - mainly saccular, usually occurs in place of the injured vessel (traumatic aneurysm), sometimes due to the destruction of its walls pathological process (arasinda aneurysm). False aneurysm is formed from the pulsating hematoma by sprawl around her connective tissue; the aneurysm formation begins on 12-17 day after the injury. With traumatic aneurism artery may be communicated through aneurysmal scar bag or directly adjacent vein, if the latter was also wounded (arteriovenous aneurysm). There are various options traumatic aneurysms. They are usually localized where the vessel is lying deep in the tissues (for example, the femoral artery) and his injury (especially firearms) may not be abundant cause external bleeding; in this case the injured vessel often gets overlooked.
Traumatic aneurysm causes blood flow disorders, threatens ischemic gangrene limbs, bleeding at rupture of the aneurysm, suppuration in aneurysmal bag. Festering aneurysm may be adopted for abscess and opened, which will cause dangerous bleeding. Arteriovenous aneurysm, in addition, leads to varicose expansion of veins. Arteriovenous aneurysm large vessels (iliac, subclavian, neck) causes disturbance of activity of the cardiovascular system.
Core topic traumatic aneurysm. I - noise auscultation in the area of the aneurysm: intermittent, continuous synchronous, but increasing pulse when the push (for arteriovenous aneurysm). Noise is transmitted over the course of the vessels on long distance, in different directions depending on the type of aneurysm. The second important feature is throbbing, swelling in the course of the vessel may be missing if the aneurysm is not bag (arteriovenous fistula).
Treatment: excision of the aneurysm with the subsequent imposition of vascular suture (see), and at impossibility of it with ligation of vessels. In the preoperative preparation of the most important place is given to the training of collaterals (see Ligation of the blood vessels).

Aneurysm (gr. aneurysma, from aneuruno - extend - the extension of the lumen of blood vessel in a limited area due to protrusion of the vascular wall. This definition refers to the most common types of aneurysms and does not meet the variety of changes of the vascular system, denoted by this term. Ballooning is a fundamental characteristic of aneurysms; however, if it does not have a locally-limited nature and is not associated with previous gross structural changes of the vessel wall, it is called not A. and ectasia. However, there anatomical variation diffuse A., at which the extension is known length on clinico vessel and the line between aneurysms and ectasia is erased. There are special varieties A. - dissecting and arteriovenous under which generally prioritize the arterial wall missing.
Due to the fact that in the above generally accepted definition of A. not fit all processes with that name, there was a division A. on the true and the false. Under the false aneurysm understand chamber connected with the vessel lumen cavity lying outwards from its walls. The development of this cavity is preceded by a periarterial hematoma that formed due injured artery, with subsequent autolysis the Central part and the development of fibrosis peripheral layers (see below Traumatic aneurysm). When establishing communication between an artery and adjacent Vienna formed the so-called arteriovenous A.; the latter sometimes occurs as malformation, often as a result of injury (firearm, knife, and others). In connection with the generally accepted definition, it should also be pointed to development A. not only in the arteries, but in the heart. From the above follows the diversity of morphology and pathogenesis A. and known conditionality very definition of this concept. On this basis, it was suggested to call And the expansion of blood Lodge regardless of its origin.