Abdominal Aortic Aneurysm Quiz- Case 17 – WFUMB

Question 1 of 2

1. Question
Clinical Description:

55 yr old lady awoke with severe abdominal pain and vomiting. An initial ultrasound was performed (images 1 to 4). Based on these initial images –

Is there an abdominal aortic aneurysm?
- 1. Yes
- 2. No
- 3. Indeterminate as the entire abdominal aorta could not be imaged adequately.
Correct

The proximal abdominal aorta can be seen but the distal aorta cannot be adequately visualised, so an AAA cannot be excluded. An “inderminate” finding should be expected in 10-20% of scans when performed by less experienced users.

Incorrect
Question 2 of 2

2. Question
Clinical Description:

55 yr old lady awoke with severe abdominal pain and vomiting.

As the distal aorta could not be adequately visualised initially, the following technique was used …
- 1. Repeat after filling bladder to push bowel superiorly.
- 2. Left lateral (along rectus sheath) and left flank (renal) windows
- 3. Prone position with paraspinal window.
- 4. Standing patient up.
Correct

If the aorta cannot be visualised using the normal abdominal window, then try a lateral approach (along the edge of the rectus sheath, usually requires quite a lot of pressure, find the spine then fan the beam anteriorly until you find the aorta as shown in the video loop) or using the kidney as a window (in this case there is also hydronephrosis from the renal calculus that was the cause of this patient’s symptoms).

Incorrect

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