SONOWORLD : Abdominal aortic dissection

Username

Password

185,322 Registered Members as of 01/23/2021.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Vascular » Aortoiliac

Abdominal aortic dissection

« Back to Listing

Author(s) :

Patrick Perkins, MD

Wayne Leonhardt, BA, RT, RDMS, RVT

Presentation Patient is a 53 year old man who arrived in the Emergency Room complaining of epigastric pain. He stated the pain at times radiated to his back and he felt pressure in his chest. He had no other symptoms. The patient's medical history included hypertension and nephrolithiasis. He smoked a pack of cigarettes a day and was obese. He was evaluated for a myocardial infarction. An EKG showed a normal sinus rhythm. Chest X-ray and all lab values were within normal limits. He had no rebound tenderness or nausea. He was given oxygen and started on nitroglycerin and aspirin. The patient was admitted to the ICU for angina and observation. Subsequent abdominal Ultrasound and Chest CT scans were ordered.

Caption: Sagittal Abdominal Aorta

Description: Note echogenic interface within aorta and parallel to the aortic walls.

Caption: Transverse Abdominal Aorta

Description: A thin echogenic layer is seen within the aorta, suggesting a membrane.

Caption: Color Doppler of Abdominal Aorta

Description: Color Doppler of the abdominal aorta demonstrates normal-appearing blood flow anterior to the echogenic membrane and minimal flow posterior to it.

Caption: Origin of Right Iliac Artery

Description: The echogenic membrane extends into the right iliac artery.

Caption: Sagittal Left Iliac Artery

Description: This sagittal view of the left iliac artery also shows the membrane extending from the abdominal aorta into the iliac artery.

Differential Diagnosis Thrombus within aorta
Retained catheter

Final Diagnosis Extensive aortic dissection along the entire course of the abdominal aorta and into the iliac arteries. The femoral arteries were not involved.

Technical Details Case provided courtesy of Siemens.

Other Cases in This Category

Vascular >> Aortoiliac

Aortic aneurysm with intraluminal thrombus
A 60 year old man presented with vague pain in the abdomen of four months duration. A bruit was heard over the aorta, in the infraumbilical region. All peripheral pulses were well felt.

Spontaneous aortic dissection
A 67year-old woman presented with excruciating, non-radiating pain in the peri-umbilical region. She also complained of back pain which started at about the same time as the abdominal pain. An ...

Mural thrombus in the aorta
A 95 year old male presented with right calf pain and shortness of breath. He was diagnosed with pulmonary embolism and acute right deep vein thrombosis. His past medical history is significant ...

Syphilitic aortitis
A 47 year old asymptomatic Caucasian male presents with complaints of a slow growing pulsatile mass at the right upper chest

Ruptured abdominal aortic aneurysm
A 62-year-old man presented with spontaneous pneumothorax, lumbar pain and pain in the lower limbs. Biochemical investigations revealed a low hemoglobin and hematocrit. Plain abdominal ...

Abdominal Aorta Aneurysm
61 year old asymptomatic male patient. Smoker of 2 packages of cigarettes/day for many years. A screening abdominal sonogram was performed.

Dissection of the aorta and the left iliac artery
62 year old male patient who was examined by a cardiologist a few days earlier because of sudden severe chest pain. The cardiologist could not find an abnormality. The pain is now mainly located ...

Dissection of abdominal aortic aneurysm
This is the scan of the abdominal aorta in a 40-year-old man with this established diagnosis.