A 72year old man with left flank pain referring to testeis

 

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Doctor's Information

Name : Morteza
Family :Sanei Taheri
Affiliation : Radiology Department,Shohada Tajrish Hospital,SBMU

Academic Degree: Associate Professor of Radiology

Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Jaleh Falahat

 

Patient's Information

Gender : Male
Age : 72

 

Case Section

Cardiovascular

 

Clinical Summary

A 72/y old man with left flank pain referring to testis since about 3-4 hours before admission

 

 

Imaging Procedures and Findings

The abdominal aortic aneurysms in dimension of 82*78 mm located above the aortic bifurcation, and the internal hypo-echoic area, which demonstrates thrombus within aneurysms, were observed. The thrombus extends to the bifurcation, but determining the exact upper limit was not possible due to the bowel gas. The aortic fusiform aneurism infra renal artery origin was seen (infrarenal aneurism). The mural thrombus with internal extravasations was also observed. The retroperitoneal hematoma in the left pararenal space could be seen which indicates the external extravasations.The patient died due to cardiac arrest before surgery.

 

Discussion

The most common etiology of abdominal aortic aneurysms is degenerative. An atherosclerotic AAA is defined as enlargement of the aorta at least 1.5 times greater than the normal vessel diameter. Atherosclerotic AAAs are for the most part fusiform and often lined with mural thrombus. Although US does demonstrate the aneurysm, CT has become the diagnostic study of choice. US can detect periaortic fluid as can be seen with leakage. Rupture of an AAA has a high mortality rate. CT is better for evaluation of rupture, since it is not compromised by bowel gas.

 

Final Diagnosis

rupture of AAA

 

References

John F. MacGahan, Barry B. Goldberg (eds), Diagnostic Ultrasound,2nd edition; Brant WE, Helms CA. Fundamentals of Diagnostic Radiology, 3rd edition.

 

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