ANEURISMA

BAGIAN BEDAH
FAKULTAS KEDOKTERAN
UNIVERSITAS YARSI
Aneurysms

 A permanent localized dilation of an

artery to one and one-half or more times
is normal diameter

 Forms at a weak point in vessel wall

Classification of Aneurysms

 Location  Etiology
 Central - degenerative
 Peripheral - inflammatory
 Splanchnic
- menchanical
 Renal
- congenital
 Cerebral
- dissecting
 Appearance
 Fusiform  Structure
 Saccular  True
 Dissecting  False
Pemeriksaan

 CT Scan
 MRI
 Angiografi
 USG
Abdominal Aortic Aneurysm

 If untreated, outcome is rupture

 Possible to palpate when reached 5 cm
 Clinical manifestations (if any):
 Pulsating mass
 Compression of structures can cause mottling of
lower extremities
 Abdominal pain
 Back pain

 CT and US are most accurate diagnostic tools

Ruptured Aneurysm

 Abdominal pain with intense back pain or

scrotal pain
 Obvious pulsating mass
 Rigid abdomen
 Syncope
 Hemorrhagic shock
 WBC increase, RBC decrease
Thoracic Aortic Aneurysms

 Clinical Manifestations
 Constant pain when supine
 Chest pain
 Dyspnea
 Cough
 Hoarseness
 Dysphagia
Surgical Repair of An Aneurysm

 Abdominal Aortic Aneurysm Repair

(AAA) is major surgery
 Endovascular repair
 Preoperatively, need complete baseline
data – including checking distal pulses
 Post-operatively need critical monitoring
Dissecting Aneurysm

 Longitudinal Splitting between layers

 Clinical Manifestations
 Excrutiating pain
 Hypertension
 Diminished pulses
 Chest Xray shows widened mediastinum
 Muffled heart sounds

 Management aimed at decreasing BP and

surgically repairing aorta
Aneurysms of the Peripheral
Arteries

Femoral and popliteal aneurysms

Symptoms: limb ischemia, diminished or

absent pulses, cool to cold skin, and pain
Treatment: surgery
Postoperative care: monitor for pain
Aortic Dissection

May be caused by a sudden tear in the

aortic intima, opening the way for blood
to enter the aortic wall
Pain described as tearing, ripping, and
stabbing
Emergency care goals include:
Elimination of pain
Reduction of blood pressure
Decrease in the velocity of
left ventricular ejection
Nonsurgical treatment
Surgical treatment
Terima Kasih