A small lump on anterior abdominal wall. On ultrasound, this was highly vascular. CT angiogram was performed.
CT Angiogram Abdominal Aorta
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CT angiogram demonstrates smooth tapering of the infrarenal abdominal aorta, with a return to normal caliber distally resulting in an 'hour glass' shape. No atheroma or inflammation.
Note the prominent truncal collaterals and the enlarged internal mammary arteries and inferior and superior epigastric vessels, one of which loops near the skin surface - the palpable anomaly which led to the diagnosis.
The case was discussed at the local vascular MDM where a diagnosis of mid-aortic syndrome was agreed. The patient is asymptomatic and no intervention or follow-up was planned.