Radiology Teaching Files > Case 12115043

Contributed by: Demetrios Georgis, Radiology Technologist, Community Health Network, Indiana, USA.
Patient: 73 year old male
History: Patient has history of chronic liver cirrhosis. The patient appeared coherent of his surroundings and was admitted into the hospital for epigastric pain and abdominal distension. A portable ultrasound was ordered to evaluate the presence of ascites.
This case has no images yet.
Findings: While evaluating all four abdominal quadrants for ascites, a large anechoic tubular structure was visualized. This structure was the abdominal aorta. Color Flow and Doppler were used to evaluate and diagnose the incidental finding. The aneurysm reaches from the proximal portion to the distal portion of the aorta. There was no evidence of thrombus or dissection. The patient had no previous aortic exams and therefore was unaware of the serious threat of his pathology.
Diagnosis: There is a large fusiform aneurysm in the mid abdominal aorta with a maximal AP diameter of 5.6 cm and a approximate length of 9.6 cm. No obvious dissection is visualized nor any periaortic leak.
Discussion: An aneurysm is defined as a localized dilatation of a vessel. Men over the age of 65 make up the majority of the patient pool, however other age groups and females are not excluded. The most common cause for the occurence of an aneurysm is arteriosclerosis, which is an abnormal thickening and hardening of the arteries leaving them without their normal elasticity. A palpable pulsatile mass may felt on a patient by a physician during his or her regular physical examination. This is not always indicative of a aneurysm, an abdominal mass or enlarged kidney may present with similar clinical evaluation. The evaluation of the aorta is highly recommended after the possibility of an aneurysm is questioned. Factors associated with AAA: - cigarette smoking - diabetes - hypertension - high levels of cholesterol All of these plus others many contribute to the formation of an abdominal aortic aneurym. Different types of aneurysms include: - fusiform - saccular - dissection - ectatic - mycotic - false (a tear in the wall of the artery that does not pierce all three layers of the vessel and allows blood to fill in between each layer giving an aneurysmal appearence. This dilatation may increase and decrease in size with systole and diastole.)
References: Gill, Kathryn A.: Abdominal Ultrasound - A Practitioner's Guide Philadelphia, 2001, Saunders Hagen-Ansert, Sandra L.: Textbook of Diagnostic Ultrasonography/Volume One/Fifth Edition, St. Louis, 2001, Mosby, Inc.
No comments posted.
Additional Details:

Case Number: 12115043Last Updated: 12-02-2007
Anatomy: Vascular/Lymphatic   Pathology: Vascular
Modality: USExam Date: 10-23-2007Access Level: Readable by all users
Keywords: fusiform aneurysm

The reader is fully responsible for confirming the accuracy of this content.
Text and images may be copyrighted by the case author or institution.
You can help keep MyPACS tidy: if you notice a case which is not useful (e.g. a test case) or inaccurate, please contact us.