関: aortic rupture

WordNet

state of being torn or burst open
the act of making a sudden noisy break
a personal or social separation (as between opposing factions); "they hoped to avoid a break in relations" (同)breach, break, severance, rift, falling out
a cardiovascular disease characterized by a saclike widening of an artery resulting from weakening of the artery wall (同)aneurism

PrepTutorEJDIC

〈U〉〈C〉(…の)破裂《+『of』+『名』》 / 〈U〉〈C〉(友好的関係などの)決裂,仲たがい / 〈C〉裂け目 / 〈C〉脱腸,ヘルニア / …‘を'破裂させる / 〈友好関係など〉‘を'断ち切る / 破裂する
動脈瘤(りゅう)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/11/15 09:30:50」(JST)

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Aortic rupture is the rupture or breakage of the aorta, the largest artery in the body. Aortic rupture is a rare, extremely dangerous condition. The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously.

Aortic rupture is distinct from aortic dissection, which is a tear through the inner wall of the aorta that can block the flow of blood through the aorta to the heart or abdominal organs.

An aortic rupture can be classified according to its cause into one of the following main types:

Traumatic aortic rupture
Aortic rupture secondary to an aortic aneurysm^[1]

Signs and symptoms

Symptoms

Tearing pain, located in the abdomen, flank, groin, or back
Loss of consciousness

Signs

Low blood pressure from hypovolemic shock
Fast heart rate
Blue discoloration of the skin
Altered mental status
Bruising of the flank, a sign of retroperitoneal bleeding.

Causes

The most common cause of aortic rupture is a ruptured aortic aneurysm. Other causes include trauma and iatrogenic (procedure-related) causes.

Mechanism

The wall of the aorta is an elastic structure which requires integrity. Rupture results from either loss of wall strength to the point at which systemic pressure is greater than wall strength, or external destruction of the wall of the aorta, by a tumor or traumatic means.

The bleeding can be retroperitoneal or intraperitoneal, or the rupture can create an aortocaval or aortointestinal (between the aorta and intestine) fistula.

Diagnosis

Diagnosis is often suspected in patients in extremis (close to death) with abdominal trauma or with relevant risk-factors. Diagnosis is confimed quickly in the Emergency room by ultrasound or CT scan.

Prevention

Aortic aneurysms are treated prophylactically (prior to symptoms) to prevent rupture. Once an aneurysm has developed, it does not regress, so the only treatment is surgery, either endovascular aneurysm repair (EVAR) or open aortic surgery.

Treatment

Aortic ruptures can be repaired surgically via open aortic surgery or using endovascular therapy (EVAR), regardless of cause, just as non-ruptured aortic aneurysms are repaired. An aortic occlusion balloon can be placed to stabilize the patient and prevent further blood loss prior to the induction of anesthesia.

Prognosis

Mortality from aortic rupture is up to 90%. 65–75% of patients die before they arrive at hospital and up to 90% die before they reach the operating room.^[2]

References

^ Ruptured Aortic Aneurysm at Patient UK. Original Author: Laurence Knott. Current Version: Gurvinder Rull. Peer Reviewer: Hannah Gronow. Last Checked: 16/05/2012
^ Brown, LC; Powell, JT (September 1999). "Risk factors for aneurysm rupture in patients kept under ultrasound surveillance. UK Small Aneurysm Trial Participants.". Annals of surgery 230 (3): 289–96; discussion 296–7. doi:10.1097/00000658-199909000-00002. PMC 1420874. PMID 10493476.

UpToDate Contents

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1. 症候性（未破裂）腹部大動脈瘤および腹部大動脈瘤破裂のマネージメント management of symptomatic non ruptured and ruptured abdominal aortic aneurysm
2. 腹部大動脈瘤の臨床的特徴および診断 clinical features and diagnosis of abdominal aortic aneurysm
3. 腹部大動脈瘤破裂の外科的および血管内修復 surgical and endovascular repair of ruptured abdominal aortic aneurysm
4. 胸部大動脈瘤のマネージメントおよび転帰 management and outcome of thoracic aortic aneurysm
5. 胸部大動脈瘤の疫学、危険因子、病因、および自然史 epidemiology risk factors pathogenesis and natural history of thoracic aortic aneurysm

English Journal

Effect of macroscale formation of intraluminal thrombus on blood flow in abdominal aortic aneurysms.

Raptis A1, Xenos M2, Dimas S3, Giannoukas A4, Labropoulos N5, Bluestein D6, Matsagkas MI1.
Computer methods in biomechanics and biomedical engineering.Comput Methods Biomech Biomed Engin.2016 Jan 2;19(1):1-9. doi: 10.1080/10255842.2014.989389. Epub 2015 Jan 14.
A mathematical approach of blood flow within an abdominal aortic aneurysm (AAA) with intraluminal thrombus (ILT) is presented. The macroscale formation of ILT is modeled as a growing porous medium with variable porosity and permeability according to values proposed in the literature. The model outli
PMID 25586707

Bicuspid aortic valve aortopathy in adults: Incidence, etiology, and clinical significance.

Michelena HI1, Corte AD2, Prakash SK3, Milewicz DM3, Evangelista A4, Enriquez-Sarano M5.
International journal of cardiology.Int J Cardiol.2015 Dec 15;201:400-7. doi: 10.1016/j.ijcard.2015.08.106. Epub 2015 Aug 10.
Bicuspid aortic valve is the most common congenital heart defect and is associated with an aortopathy manifested by dilatation of the ascending thoracic aorta. The clinical consequences of this aortopathy are the need for periodic monitoring of aortic diameters, elective prophylactic surgical aortic
PMID 26310986

Ruptured splenic artery aneurysm detected by emergency ultrasound-a case report.

Lo WL1, Mok KL.
Critical ultrasound journal.Crit Ultrasound J.2015 Dec;7(1):26. doi: 10.1186/s13089-015-0026-4. Epub 2015 Jun 10.
Splenic artery aneurysm is a rare but a potentially fatal condition. It is usually asymptomatic until it ruptures. Here, we present a case of ruptured splenic artery aneurysm in a 59-year-old gentleman presenting with epigastric pain and hypovolemic shock. The diagnosis was made by emergency ultraso
PMID 26069053