False aneurysm
Aneursym pathology
- Definition
- Abnormal localised dilation of an arterial blood vessel (cf varix of a vein)
- Causes
- Traumatic
- Inatrogenic
- Shape Classification
- Fusiform
- Saccular
- False: cavity in a haematoma which connects with the lumen of the artery
- Pathological classification
- True: all layers of arterial wall
- False: partial laceration of vessel wall causing blood to leak out of the vessel into the surrounding tissues (same as a pulsating haematoma) - fibrous tissue forms around haematoma which then contracts, producing a false sac which contains thrombus but remains connected to the lumen of the damaged vessel: pulsation transmitted from the artery tends to increase the size of the cavity with time
Approach
- Expose abdomen
- Inspection
- Presence of surgical scars over the abdomen
- Palpation
- Think about incisional herniaes over scar
- Describe pulsatile swelling
- Define anatomy of swelling: midline, lateral - ascertain artery involved
- Continue to palpate femoral pulses
- Percussion
- Auscultation
- May be bruit over swelling
Treatment options
- Observe and review
- USS compression of false aneurysm
- Thrombin injection
- Surgical repair
