Quotation from: Manual of SurgeryWritten by: Alexander Miles and Alexis Thomson |
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The _clinical features_ vary with the site of the aneurysm and with its rapidity and direction of growth. A smooth, rounded swelling, which exhibits expansile pulsation, forms, usually towards the left of the middle line. It may extend upwards under cover of the ribs, downwards towards the pelvis, or backward towards the loin. On palpation a systolic thrill may be detected, but the presence of a murmur is neither constant nor characteristic. Pain is usually present; it may be neuralgic in character, or may simulate renal colic. When the aneurysm presses on the vertebrae and erodes them, the symptoms simulate those of spinal caries, particularly if, as sometimes happens, symptoms of compression paraplegia ensue. In its growth the swelling may press upon and displace the adjacent viscera, and so interfere with their functions.
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