Presentation
Abdominal pain, palpable abdominal mass.
Patient Data
Fusiform aneurysmal dilatation of the infrarenal aorta measuring about 7x6 cm in its maximum axial diameters and extends for about 13 cm in length. A mural crescentic thrombus is seen with a linear contrast streak seen extending from the lumen into the mural thrombus indicative of thrombus fissuration.
Mural calcifications are noted.
Other findings: left renal stone, right renal simple cyst, dorsolumbar spondylodegenerative changes.
A mural crescentic thrombus is seen with a linear contrast streak (red arrow) seen extending from the lumen into the mural thrombus indicative of thrombus fissuration.
Case Discussion
An aneurysm is defined as a more than 50% increase in diameter compared with the expected normal diameter vessel. A less than 50% increase is termed ectasia.
An infrarenal aorta considered to be aneurysmal if it is 3 cm in diameter or greater. Some authors consider 3.5 cm in diameter to be a better “cut off point.”
Aortic wall degeneration secondary to atherosclerotic disease, as in our case, is probably the most common cause responsible for the formation of AAAs.
Thrombus fissuration is a worrisome sign that may point to impending rupture of an aortic aneurysm.