I checked with the Mods that I could ask this medical question. It doesn’t pertain to myself but to my late father.
My father had a back operation (in the lower abdominal region) in April, 2006. My father underwent various scans before this operation, the specifics of which I’m not sure but could find out if it would better answer my query.
At the end of May, 2006 my father died suddenly of what we found out was a lower abdominal aneurysm. He was a smoker and had a history, having had an operation on another aneurysm in 1995.
My mother wants to know whether the scans that my father underwent before the operation should have detected the aneurysm and also whether an aneurysm can manifest and be fatal in the roughly 45 day period between the operation and his passing.
I’m looking for factual answers please.
Thanks in advance for any information any medical professionals can provide me,
An Gadaí
Your post does not provide anywhere near enough data for an informed response. Your best course of action would be to obtain the radiology reports of the ‘scans’ that he had, as well as copies of the actual scans, and have them reviewed by some other radiologist.
It is vanishingly unlikely that he went from normal to ruptured aneurysm in 45 days; the aneurysm was almost certainly there already. Rupture rates for aneurysms are correlated to size, but rates are expressed as percentage of rupture over 12 months: i.e. asymptomatic aneurysms between X.X and Y.Y cm have a Z% chance of rupture in the following year.
Yes I know my OP was sketchy. Thanks for your reply. I will try to retrieve the radiology reports and talk to a radiologist. Thanks again for your help.
On rereading my post I think that it sounds more curt than I intended, for which I apologize.
If the aneurysm does show up on the scans (MRI? CT? with or without iv contrast? bone scan?) please bear in mind that not all asymptomatic aneurysms are operated on - just those in which the risk of spontaneous rupture is greater than the risk of death due to surgery. Even if an aneurysm is large enough to be operated on, other surgeries may have higher priority.
As both an MD and someone who’s had seven “back operations” (with #8 scheduled for 3 weeks from now), I can tell you that most “scans” done with respect to a back operation would not see an abdominal aneurysm. By and large, before back operations, the surgeons are only interested in scans of the spine and associated tissues. Abdominal aneurysms are very unlikely to be picked up by, say, a spinal MRI. (aneurysms are higher up than most lumbar surgeries [the most common “back” operation] and also more towards the front)
As was mentioned, the odds are a virtual certainty that the aneurysm was there for years before it burst. Even if detected, it may not have justified surgical removal. For example, if the risk of it bursting was estimated to be 2% per year, but the risk of the aneurysm operation was estimated to be 10% for death, then no one would likely opt for O.R. Make sense?
Yes, makes perfect sense. I can find out exactly the nature of the scans but your reply pretty much clears things up for me. Thanks again for the information.
As an X-ray tech, I can mention that, occasionally, an AAA (Abdominal Aortic Aneurysm) can appear on a lateral lumbar spine radiograph. (That’s why we leave the field open a little wider on lat lumbars–just to look for these things in case they exist.) Typically, though, the patient has to be old enough so that some calcification of the aorta has occurred thereby making the AAA visible.
Otherwise, unless some type of contrast study was done using a radiopaque agent, the AAA might not be easily seen.
If a Radiologist did note evidence of an AAA, then it’s up to the patient’s primary care physician to follow up.