Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0000737 (abdominal pain)
 31,184 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Inflammatory abdominal aortic aneurysm (AAA) accounts for 5% to 10% of all cases of AAA and differs from typical atherosclerotic AAA in many important ways. Although both inflammatory and atherosclerotic AAA most commonly affect the infrarenal portion of the abdominal aorta, patients with the inflammatory variant are younger and usually symptomatic, chiefly from back or abdominal pain. Unlike patients with atherosclerotic AAA, most with the inflammatory variant have an elevated erythrocyte sedimentation rate or abnormalities of other serum inflammatory markers. Computed tomography and magnetic resonance imaging are both sensitive for demonstrating the cuff of soft tissue inflammation surrounding the aneurysm that is characteristic of inflammatory AAA. In contrast to atherosclerotic AAA, the inflammatory variant is characterized pathologically by marked thickening of the aneurysm wall, fibrosis of the adjacent retroperitoneum, and rigid adherence of the adjacent structures to the anterior aneurysm wall. An extraordinary expansion of the adventitia due to inflammation also distinguishes inflammatory from atherosclerotic AAA. Although the pathogenesis of inflammatory AAA appears to involve an immune response localized to the vessel wall, the etiology of the inflammatory reaction is unknown. Inflammatory AAA is almost never associated with inflammation of other arteries. Male sex and smoking, the main risk factors for atherosclerotic AAA, are even stronger risk factors for the inflammatory variant. Smoking cessation is the first step of medical therapy. Corticosteroids or immunosuppressive therapies may also have roles. Although inflammatory AAA appears less likely to rupture than atherosclerotic AAA, surgical intervention appears prudent once the diameter of the aneurysm exceeds 5.5 cm. Knowing the features of inflammatory AAA should allow physicians to distinguish it from atherosclerotic AAA or from systemic vasculitis and to treat it with the appropriate combination of medical and surgical therapies.
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PMID:Inflammatory abdominal aortic aneurysm. 1724 36

Inflammatory abdominal aortic aneurysm is a rare cause of abdominal pain in young adults that may be difficult to diagnose in the Emergency Department. This case highlights the significance of this condition as a possible diagnosis in young patients presenting with abdominal symptoms. A 32-year old woman presented with lower abdominal and back pain. She had four previous visits to the Emergency Department and one hospital admission with similar symptoms and had been discharged without a definite diagnosis. Her vascular risk factors included hypercholesterolemia and smoking. A computed tomography (CT) scan showed a non-leaking infrarenal saccular abdominal aortic aneurysm and para-aortic lymphadenopathy. A transthoracic echocardiogram excluded endocarditis. There was no evidence of bacterial, viral, or fungal infection on blood and serum assays, and her autoimmune screen was negative. She underwent urgent open repair using a synthetic graft. The aneurysmal wall and para-aortic lymph node histology confirmed the diagnosis of inflammatory aneurysm with periaortitis. She remained asymptomatic at 8 months after surgery with no evidence of additional aneurysmal disease. Inflammatory abdominal aortic aneurysm is an unusual cause of abdominal pain in young adults. It is more likely in patients with persistent or recurrent abdominal symptoms.
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PMID:Inflammatory infrarenal abdominal aortic aneurysm in a young woman. 1802 83