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That is Case 04 completed – to move on to Case 05 ~ click here
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Question 1 of 2
1. Question
Clinical Description:
74 yr old male with dull back ache after lifting furniture. The medical student suspects a pulsatile abdominal mass on their examination.
Describe the findings …
Correct
The aorta is not the only longitudinal, pulsatile vascular structure in the abdomen. The IVC is the vessel in the first 2 images and must not be mistaken for the aorta. Starting with transverse imaging will help prevent this. Loop 03 shows fanning right to left from the IVC onto the aorta.
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Question 2 of 2
2. Question
Clinical Description:
74 yr old male with dull back ache after lifting furniture. The medical student suspects a pulsatile abdominal mass on their examination.
What is the appropriate management?
Correct
Although this is likely an incidental finding and the symptoms are probably due to mechanical back pain, a slow rupture cannot be excluded clinically so CT angiogram should be performed. The risk of rupture of an aneurysm of this size is high (25% at 6 months) so urgent referral to vascular surgery is recommended even if there is no leak.
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