Abdominal aortic aneurysm

Case contributed by Dr Mohamed Hossam el Deen

Presentation

The patient has a long history of hypertension, hyperlipidaemia, IDDM. He came for follow up visit.

Patient Data

Age: 68
Gender: Male
Modality: CT

Tri-phasic CT of abdomen and pelvis showing fusiform shaped abdominal aortic aneurism at L1/L2 level and not reaching renal vessels, measuring 10.8 x 8.8 cm in CC and transverse dimensions respectively. S crescent line of intimal calcification is seen on axial images that also represents tangential calcium sign. The size of the aneurysm and intramural thrombosed  blood put the patient in high risk of aneurysmal rupture. the patient was admitted for vascular intervention.

Additional findings are:

  • Diffuse atherosclerotic changes of the thoracic and abdominal aorta as well as main iliac vessels. 
  • Bilateral renal atrophic changes more on left side.
  • 13 mm gall bladder stone.
  • Prostatomegaly.  
  • Spondylosis of dorso-lumbar spine.
  • Bilateral hip joints DJD changes.
  • Left ventricular wall hypertrophy (18 mm).
  • Inter-ventricular septum thickening (20 mm).
Modality: Ultrasound

Trans abdominal ultrasound demonstrating the aneurysm on TS view, it is clearly showing mural thrombosis of vessel wall and mosaic pattern of color doppler due to blood turbulence.

Case Discussion

Male sex, old age (above 65 years), long standing hypertension, long history of IDDM, cigarette smoking and less importantly hyperlipidaemia. All are risk factors for AAA. All are present in this patient. 

The most important step in radiological imaging is the dimension of the aneurysm. Here the aneurysm is more than 5 cm in maximal diameter which is an indication for vascular intervention.

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Case Information

rID: 46906
Case created: 22nd Jul 2016
Last edited: 24th Jul 2016
System: Vascular
Inclusion in quiz mode: Included

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