Abdominal Aortic Aneurysm with Thrombus
Abdominal Aortic Dissection (Transverse)
Abdominal Aortic Aneurysm with ThrombusApproximately 6 cm abdominal aortic aneurysm with intramural thrombus. Frances Russell, MD, RDMSAssistant Professor of Emergency Medicine Division Chief, Ultrasound Fellowship Director, Ultrasound
Ruptured AAAThe clip above is from a patient who presented with abdominal pain and syncope. His vitals were notable for tachycardia and hypotension. The image demonstrates a very large abdominal aortic aneurysm with anterior free fluid suggestive of rupture. The patient was taken emergently to the operating room for endograft repair and did well. Jason Tanguay, DO
Abdominal Aortic Dissection (Transverse)Aortic dissection carries an incredibly high mortality that increases 1 percent per hour. POCUS can be used as a rule-in test to quickly identify this life threatening diagnosis. If a dissection is not seen on POCUS, CT angiography should still be be performed because this test's sensitivity is not as high as for other indications. The spine can be used as a landmark, the echogenic stripe with shadowing in the midline. The aorta is the large vessel anterior and slightly to the right of the spine. In this image an intimal flap can be see in the anterior third of the aorta consistent with an aortic dissection. The IVC cannot be clearly visualized in this image but would normally be left, less pulsatile with a less echogenic vessel wall. Non-visualization of the IVC is most often due to bowel gas or simple compression of the abdomen with the probe. Justin Bowra MBBS, FACEM, CCPU Emergency Physician, RNSH et al.
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