Can severe vomiting cause and abd. aneurysm to grow or burst?

Question

My husband just got over a bad case of an intestinal 'bug'. He caught it from me. He's a large man and he threw up 3 or 4 times--violently. He's so sore all over now. He has an abdominal aneurysm--size now is 4.8.
Can this ever cause a problem with this condition when one 'throws up' so hard? No symptoms now of course, but you can't help but be concerned. thanks
yanksgirl

Answer 1

Although I know of no data which specifically addresses your concern, I would think it unlikely that vomiting would place him at substantial risk. The contraction of the abdominal muscles against a closed glottis while vomiting does cause an increase in intraabdominal pressure. However that pressure is exerted on the outside of the aneurysm, squeezing and contracting it, and forcing blood outward towards the legs. The effect would be the same as placing you hand over an expanded section of a hose and applying pressure.

Thus the effort of vomiting would be quite different from the effect of sudden strenuous exercise. In that case a quick increase in heart activity would increase blood pressure from within the aorta, risking a rupture.

Obviously there is also an exercise-like effort in vomiting, but I would guess that the intraabdominal pressure effect would be the predominant one, and would be protective.

Answer 2

In keeping with the Law of Laplace, an aortic aneurysm inevitably slowly expands, a process made more likely by hypertension. The rate of expansion is highly variable both between patients and for the individual patient over time. Thus the lifetime threat posed by a 5 cm AAA (Abdominal aortic aneurysm) is considerably greater for someone aged 50 years than it is for someone over 75. The risk of rupture is related to the size of the aneurysm: the normal aorta is 1.5-2.5 cm in diameter and is defined as aneurysmal when it attains twice that diameter- in excess of 4 cm.The reported annual risk of rupture varies quite widely but is probably in the region of :
4 cm: 1 -2%
5 cm: 5-10%
6 cm: 10-15%
7 cm: more than 20%
Only a third of patients with rupture live long enough to reach hospital, and of those that are operated upon, only half survive. Thus the overall (community) mortality for rupture is as high as 80-90% and possibly many other deaths occur from rupture of an undiagnosed, asymptomatic aneurysm.
Please also note that it is possible to form a moving clot (thrombus) in the aneurysm sac and detach it into a moving clot (embolus). If the embolus prevents blood supply to a vital organ, it will result in death.

Answer 3

Yes. Violent retching causes your body to stiffen up and it can even hurt your back. It stresses your body. I would suggest calling the doctor to discuss it with him. Are they planning surgery anytime in the near future?

I will pray that you both get well quickly and his health continues to improve.