KLINIK, DIAGNOSTIK UND PATHOLOGIE NICHTAORTALER ANEURYSMEN

On the basis of a large autoptic material (67,352 autopsies between 1948 and 1978), clinical symptoms, diagnosis and pathologic anatomy of 140 non-aortal aneurysms (except cerebral basal arterial aneurysms) are presented. There was an accumulation beyond the 5th decade of age, among the etiologic factors atherosclerosis was predominant. 65 percent of the cases were men, 35 percent were women. Diagnosis during life time was only achieved in 16 cases (11.5 percent): in 6 cases by palpation and/or auscultation, in 4 cases by angiography, in 3 cases by an incidental intraoperative finding, in 2 cases by the help of an X-ray survey and in one case by sonography. The main reason for this low percentage of intravitally diagnosed aneurysms has to be sought in the poverty or the complete lack of clinical symptoms. If there are clinical symptoms, these are most frequently caused by a thrombosis of the aneurysm with a consecutive disturbance of arterial perfusion, and less frequently by a rupture of the aneurysm with or without compression of adjacent organs. The prerequisite for a more frequent and earlier intravital diagnosis is the inclusion of an aneurysm into differential diagnostic thinking, especially in elderly patients and unclear clinical symptomatology.