Acta Medica Leopoliensia (Feb 2019)
Rupture of a dissecting aneurysm of the abdominal aorta (a case from the practice of a district specialist)
Abstract
Cardiovascular diseases, especially in the elderly, are ranked first in the structure of morbidity and mortality. They serve as abackground for the development of other pathological conditions. In our case, diffuse arterio-atherosclerosis of the vessels in the patient, especially the aorta, led to the development of adissectinganeurysm of the abdominal aorta, which was complicated by the rupture with acute massive intraperitoneal haemorrhage, hemoperitoneum, leading toa fatal end. The diseaseoften starts unnoticed or with insignificant gastrointestinal discomfort. Aim. Drawing attention to the complexityof timely diagnosis and effective treatment of the dissectingabdominal aortic aneurysm. Material and Methods. The clinical case of the disease in the patient O., 75 years old, was analyzed; the results of the laboratory-clinical and instrumental examination were presented. However, the true cause of the severity of the patient's conditionwas not established on time. Results and Discussion. Throughout life and in the process of industrialactivity, amodern person consciously or unknowingly undergoes the influence, sometimes simultaneous and combined one, of various factors, the effect of which is sometimes detrimental to theirhealth. Over time, their negative effects are accumulated,, targetingprimarily cardiovascular and nervous system. Disturbances of macro- and microcirculation often serve as a background for the development of other pathological conditions. With age, an individual is"overgrown" with a number of interconnected, concurringdiseases; there is a polymorbidity with a syndrome of mutual exacerbationin their course. For example, today an unhealthy brand is popular: during a feast people overeat, consuming foodstuffs incompatible in the digestion and absorption (saturated with preservatives, stabilizers, flavors, etc.), accompanied bydrinking alcohol, coffee and smoking. So to what limits does one need to overload, stimulate and excite one’sbody by resorting to the above-mentioned harmful habits?! It is necessary to practice moderation in all respects. The described clinical case clearly demonstrates the difficulty in establishing the etiology of the disease, that is, not always the diagnosis lies on the surface. The beginning of the formation of aortic aneurysms is very difficult to notice in practice. The period of insignificantstretching of the aortic walls, which lasts from a few months toyears, actually does not manifest itself. A milddiscomfort in the abdomen usually goes unnoticed, especially at an older age. The available to us methods of examination and laboratory diagnostics failed contribute to the detection of this gravestate. Unfortunately, only the autopsy of the deceased has had the final say in revealing of the true cause of the serious condition of the patient. Conclusion. The following description of the disease of the patient O. confirms the pointabout the difficulties in the diagnosis of this pathology, due to the presence of nonspecific, sometimes slightly expressed, gastrointestinal symptoms, which arenot paid timely attention byeitherpatients orhealthcare workers. The ultrasound and computer methods of vascular diagnostics, available at present, should be used earlier, more frequentlyand in dynamics, especially in unclear pathological conditions, all the morein the elderly. Detecting and treating morbid conditions at the present time is not always smooth and easy. For some reason, in recent years little attention has been paid to preventing disease.
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