Abdominal Aortic Aneurysm Quiz- Case 13 – WFUMB

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Question 1 of 2

1. Question
Clinical Description:

An elderly lady presents with dizziness and vomiting. The intern thinks there is a pulsatile mass. The patient is unsure of her past medical history (due to memory loss).

Describe the ultrasound findings?
- Normal aorta.
- AAA with heavy calcification.
- AAA with dissection resulting a true and a false lumen.
- AAA with endoluminal graft.
Correct

Within the AAA is the echogenic walls of the trouser leg graft. The longitudinal view in image 5 shows one of the ‘trouser legs’ but the other is out of plane

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Question 2 of 2

2. Question
Clinical Description:

An elderly lady presents with dizziness and vomiting. The intern thinks there is a pulsatile mass. The patient is unsure of her past medical history (due to memory loss)

Is there a graft leak?
- Yes, colour flow is seen outside the graft.
- No, there is no leak.
- There is no evidence on these images, but it cannot be excluded.
- Probably, the native aorta should have shrunk onto the graft with time.
Correct

Ultrasound may sometimes show a large graft leak, but this is beyond basic AAA scanning. Colour flow may be seen behind a reflective interface (such as a graft wall) due to mirror image artefact, so be careful not to overdiagnose. Once a graft is placed there will be thrombus between the graft and the wall of the aorta (but the AAA should stop growing).

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