Varicose veins: Know quickly if they swell or burst.

A 72-year-old man was brought to the hospital with severe abdominal pain, followed by a drop in blood pressure and unconsciousness, perforated stomach, inflamed intestines, and ruptured appendix It was found from asking the patient’s treatment history from relatives that the patient had a heart bypass surgery 10 years ago and has chronic diseases, namely coronary artery disease and chronic obstructive pulmonary disease. This information made diagnosis and treatment easier. Together with severe abdominal pain, the doctor focused on the major artery in the abdomen, which is the main blood vessel connected to the heart

Dr. Vitoon Pitiguagool, Deputy Director of Cardiothoracic Surgery, Bangkok Heart Hospital, said “The above case is considered a critical complex patient that needs special attention because the surgery to treat the ruptured abdominal aortic aneurysm must clamp the major artery above the swollen and broken area immediately to prevent blood loss that could lead to shock and rapid surgery. This is because internal organs only have a short period of time without blood, such as the spinal cord, which can only last 30 minutes without blood; otherwise, there is a risk of paralysis of the lower half. In this case, the team of doctors decided to use a lateral approach, by making two incisions; one in the chest area to clamp the major artery and above the swollen and ruptured area, then they opened the abdomen from the side to avoid impacting the intestine’s function, and using artificial blood vessel technology to replace the swollen ruptured vessel to function normally again, taking a total surgery time of 19 minutes, helping the patient to survive the critical condition, and recover after rest and physical therapy.”

Abdominal Aortic Aneurysm

An abdominal aortic aneurysm is a condition in which the artery enlarges or swells due to the artery walls becoming stiff and losing their elasticity, which can occur for various reasons.

Risk Factors for Abdominal Aortic Aneurysm

There are 7 risk factors, namely:
1) Smoking
2) High blood pressure
3) High cholesterol
4) Being overweight
5) Stress
6) Genetics
7) Bloodstream infections

Treatment for Abdominal Aortic Aneurysm

For the treatment of abdominal aortic aneurysm, if the swelling does not exceed 5 centimeters, the doctor will prescribe medication with annual follow-ups via X-ray or ultrasound. However, if the swelling exceeds 5 centimeters, the doctor will increase the medication and frequency of follow-ups, along with managing risk factors. If the swollen artery ruptures, one must seek medical treatment as quickly as possible. The faster, the higher the chance of survival.

The Severity of the Disease

The terrifying thing about this disease is that patients often don’t realize it because a small swelling would not show symptoms until the swollen artery presses on a adjacent organs, then symptom such as abdominal tightness will occur. Although there’s a chance of recovery if the swollen arteries do not rupture, on the contrary, if an abdominal aortic aneurysm or elsewhere ruptures, the death rate is up to 50%.

Preventing Abdominal Aortic Aneurysm

Prevention of abdominal aortic aneurysm can be done by undergoing an annual health checkup for those younger than 30 years old. However, if you are 45 years old or older, you should focus on lung X-rays, abdomen ultrasound, liver and kidney function tests, and testing heart efficiency.

For people aged 30 – 45 years, which is a middle-aged group, need to be assessed based on the 7 risk factors mentioned earlier. If less than 3 risk factors are found, they can undergo health checks like a 30-year-old person. However, if more than 3 risk factors are identified, they should undergo health checks like people aged 45 years and older. Most importantly, if an abdominal aortic aneurysm rupture is found, one must seek medical attention as quickly as possible; the faster, the better the chance of survival. It is crucial to choose a hospital that has surgeons and the necessary equipment to perform surgery as quickly as possible.