mesenteric aneurysm
Introduction
Introduction to mesenteric aneurysms Mesentericaneurysm (mesentericaneurysm) can be divided into the superior mesenteric artery trunk, branch artery and subenteral aneurysm according to the site of occurrence, accounting for 5.5% of visceral aneurysms, the ratio of male to female is equal, and the rate of necropsy is 1/1200. The incidence of mesenteric artery rupture was 13%. basic knowledge The proportion of illness: 0.005% - 0.008% Susceptible people: no specific people Mode of infection: non-infectious Complications: rupture of abdominal aortic aneurysm
Cause
Mesenteric aneurysm
(1) Causes of the disease
The main cause of the disease is infection, accounting for 57%, the age is more than 50 years old, mainly fungal infection, bacterial endocarditis; followed by arteriosclerosis, middle membrane degeneration, the age of onset is more than 50 years old; , portal hypertension, hypertension, congenital arterial dysplasia and trauma are also the cause of this disease, but clinically rare.
(two) pathogenesis
The occurrence of mesenteric aneurysms is mainly caused by fungal and bacterial infections embolization of arterial nourishment vessels; atherosclerosis involves middle-layer elastic fibers; hypertension, Behcet's syndrome damage intima and portal hypertension cause arterial wall muscle thinning Fracture, abdominal trauma caused partial damage to the mesenteric artery to form a pseudoaneurysm.
Mesenteric aneurysms occur mostly in the superior mesenteric artery. Inferior mesenteric aneurysms are rare. Mesenteric aneurysms often cause intestinal ischemia due to thrombosis. The aneurysms adjacent to the inferior pancreaticoduodenal artery and the middle cerebral artery are blocked by thrombus. Or arterial dissection is easy to cause intestinal ischemia or even necrosis, so the collateral circulation from the femoral stem and the inferior mesenteric artery is often insufficient.
Prevention
Mesenteric aneurysm prevention
Pay attention to rest, work and rest, life in an orderly manner, and maintaining an optimistic, positive and upward attitude towards life can be of great help in preventing diseases.
Complication
Mesenteric aneurysm complications Complications abdominal aortic aneurysm rupture
Aneurysm rupture is a common complication with an incidence of about 13% and a mortality rate of 75%.
Symptom
Symptoms of mesenteric aneurysm Common symptoms Blood loss of appetite, abdominal pain, abdominal discomfort, acute abdomen diarrhea
There are 2 categories of clinical symptoms:
1. Intestinal ischemic symptoms, abdominal discomfort, and even obvious abdominal pain, diarrhea, loss of appetite, blood in the stool, weight loss, etc., blood in the stool is often caused by intestinal infarction, when the tumor is large, the abdominal pulsating mass is often seen, occasional and murmur.
2. Intra-abdominal hemorrhage symptoms due to aneurysm rupture, bleeding, acute abdomen symptoms, called "abdominal stroke", large amount of bleeding, can occur shock symptoms.
Preoperative clinical diagnosis is still difficult. Most of the tumors have no symptoms before rupture. A few may have upper abdominal discomfort. It is often considered that there is a possibility of visceral aneurysm when there is an emergency in intra-abdominal hemorrhage. Non-specific abdominal pain may occur when rupture, CT and MRA It can also show mesenteric hematoma, indirectly suggesting hemorrhage of mesenteric aneurysms. Aortic angiography is the most reliable method for the diagnosis of mesenteric aneurysms.
Examine
Examination of mesenteric aneurysms
1. CT scan and MRA examination can show mesenteric hematoma, indirectly suggest bleeding of superior mesenteric artery, SCTA and MRA have been widely used in recent years, and have high diagnostic value.
2. Aortic angiography is a reliable method to determine mesenteric aneurysms. In addition to understanding its shape, location, size, range, etc., it can also understand the blood supply of the aneurysm and its relationship with the internal organs, and clear the patients with rupture. The cause of bleeding.
Diagnosis
Diagnosis and differentiation of mesenteric aneurysms
Preoperative clinical diagnosis is still difficult. Most of the tumors have no symptoms before rupture. A few may have upper abdominal discomfort. It is often considered that there is a possibility of visceral aneurysm when there is an emergency in intra-abdominal hemorrhage. Non-specific abdominal pain may occur when rupture, CT and MRA It can also show mesenteric hematoma, indirectly suggesting hemorrhage of mesenteric aneurysms. Aortic angiography is the most reliable method for the diagnosis of mesenteric aneurysms.
