📄 SCRS
Abdominal aortic aneurysm
(AAA)
Abdominal aortic aneurysm (AAA) ultrasound case study
USG
Abdominal aortic aneurysm (AAA) ultrasound case study
Case Study Record
| SN | Case Name | Report Line |
|---|---|---|
| 1 | Infrarenal abdominal aortic aneurysm (AAA) | View Report Line |
| 2 | Suprarenal abdominal aortic aneurysm (AAA) | View Report Line |
| 3 | Juxtarenal abdominal aortic aneurysm (AAA) | View Report Line |
| 4 | Pararenal abdominal aortic aneurysm (AAA) | View Report Line |
| 5 | Aortoiliac aneurysm | View Report Line |
| Based on Etiology | ||
| 6 | Degenerative (Atherosclerotic) abdominal aortic aneurysm (AAA) | View Report Line |
| 7 | Inflammatory abdominal aortic aneurysm (AAA) | View Report Line |
| 8 | Mycotic (Infected) abdominal aortic aneurysm (AAA) | View Report Line |
| 9 | Traumatic abdominal aortic aneurysm | View Report Line |
| 10 | Pseudoaneurysm (False Aneurysm) of the abdominal aorta | View Report Line |
| Based on Integrity | ||
| 11 | Intact abdominal aortic aneurysm (AAA) | View Report Line |
| 12 | Leaking abdominal aortic aneurysm (AAA) | View Report Line |
| 13 | Ruptured abdominal aortic aneurysm (AAA) | View Report Line |
CASE–1
Abdominal Aortic Aneurysm (AAA)
Abdominal Aortic Aneurysm (AAA)
Clinical History
A 68-year-old male presented with a history of pulsatile abdominal fullness and intermittent abdominal discomfort. Ultrasound examination of the abdominal aorta was performed to evaluate for aneurysmal dilatation.
Ultrasound Findings
Ultrasound examination demonstrates a fusiform dilatation of the infrarenal abdominal aorta, measuring 4.8 × 4.5 cm in maximum transverse diameter. The aneurysmal sac contains eccentric mural thrombus with a central patent lumen demonstrating normal color Doppler flow. The aneurysm extends over a length of approximately 6.2 cm. No evidence of aneurysmal rupture, periaortic hematoma, or free intraperitoneal fluid is identified. The bilateral common iliac arteries are of normal caliber.
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| Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen. |
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Report Line
Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.
Impression
Infrarenal abdominal aortic aneurysm (AAA) No sonographic evidence of rupture.
Go To Table
Recommendation
Correlate clinically and with cardiovascular risk factors. Vascular surgery consultation is recommended. Periodic ultrasound surveillance is advised for aneurysms less than 5.5 cm in diameter. Urgent evaluation is indicated if there is rapid aneurysm enlargement, severe abdominal or back pain, or suspicion of aneurysm rupture.
Key Learning Points
- Abdominal aortic aneurysm (AAA) is defined as an abdominal aortic diameter of 3.0 cm or greater.
- Most AAAs occur in the infrarenal abdominal aorta.
- Ultrasound is the preferred screening and surveillance modality because it is rapid, accurate, and non-invasive.
- Mural thrombus is commonly present within larger aneurysms.
- Color Doppler demonstrates a patent central lumen with surrounding thrombus.
- The risk of rupture increases significantly when the aneurysm diameter exceeds 5.5 cm or shows rapid interval growth.
- Differential diagnoses include aortic ectasia, pseudoaneurysm, penetrating atherosclerotic ulcer, and aortic dissection.
CASE–2
Suprarenal Abdominal Aortic Aneurysm (AAA)
Suprarenal Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform suprarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen. |
Report Line
Fusiform aneurysmal dilatation of the suprarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm is located above the origins of both renal arteries. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.
Impression
Suprarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–3
Juxtarenal Abdominal Aortic Aneurysm (AAA)
Juxtarenal Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform juxtarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen. |
Report Line
Fusiform aneurysmal dilatation of the juxtarenal abdominal aorta measuring approximately 4.8 × 4.5 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm extends to the level of the renal artery origins without involving the renal arteries. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.
Impression
Juxtarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–4
Pararenal Abdominal Aortic Aneurysm (AAA)
Pararenal Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform pararenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen and involvement of the renal artery origin. |
Report Line
Fusiform aneurysmal dilatation of the pararenal abdominal aorta measuring approximately 4.9 × 4.6 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm involves the origin of one renal artery. No sonographic evidence of aneurysm rupture, periaortic hematoma, or retroperitoneal collection is identified.
Impression
Pararenal abdominal aortic aneurysm (AAA) involving the renal artery origin with eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–5
Aortoiliac Aneurysm
Aortoiliac Aneurysm
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform abdominal aortic aneurysm extending into the common iliac arteries (aortoiliac aneurysm) with eccentric mural thrombus surrounding a patent central lumen. |
Report Line
Fusiform aneurysmal dilatation of the distal abdominal aorta measuring approximately 5.2 × 4.9 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysm extends into the bilateral common iliac arteries, consistent with an aortoiliac aneurysm. No sonographic evidence of aneurysm rupture, periaortic hematoma, or retroperitoneal collection is identified.
Impression
Aortoiliac aneurysm involving the distal abdominal aorta and bilateral common iliac arteries with eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–6
Degenerative (Atherosclerotic) Abdominal Aortic Aneurysm (AAA)
Degenerative (Atherosclerotic) Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus and diffuse calcified atherosclerotic plaques involving the aneurysmal wall. |
Report Line
Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.0 × 4.7 cm is noted. The aneurysm contains eccentric mural thrombus with a patent central lumen. Multiple calcified atherosclerotic plaques are seen along the aortic wall, consistent with a degenerative (atherosclerotic) abdominal aortic aneurysm. No sonographic evidence of rupture or periaortic hematoma is identified.
Impression
Degenerative (atherosclerotic) infrarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus and diffuse calcified atherosclerotic plaque formation.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–7
Inflammatory Abdominal Aortic Aneurysm (AAA)
Inflammatory Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with marked circumferential wall thickening, surrounding hypoechoic inflammatory soft tissue (periaortic cuff), and eccentric mural thrombus. |
Report Line
Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.1 × 4.8 cm is noted with circumferential aneurysmal wall thickening, surrounding hypoechoic periaortic inflammatory soft tissue, and eccentric mural thrombus with a patent central lumen. The findings are consistent with an inflammatory abdominal aortic aneurysm. No sonographic evidence of aneurysm rupture or periaortic hematoma is identified.
Impression
Inflammatory abdominal aortic aneurysm (AAA) with circumferential wall thickening, periaortic inflammatory soft tissue, and eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–8
Mycotic (Infected) Abdominal Aortic Aneurysm (AAA)
Mycotic (Infected) Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a saccular abdominal aortic aneurysm with an irregular thickened wall, surrounding periaortic inflammatory soft tissue, and eccentric mural thrombus, suspicious for a mycotic (infected) aneurysm. |
Report Line
An irregular saccular aneurysmal dilatation of the abdominal aorta measuring approximately 4.6 × 4.3 cm is identified. The aneurysm demonstrates a thick irregular wall, eccentric mural thrombus, and surrounding periaortic inflammatory soft tissue. A patent central lumen is present on Color Doppler examination. The sonographic findings are highly suggestive of a mycotic (infected) abdominal aortic aneurysm. No definite sonographic evidence of rupture is identified.
Impression
Mycotic (infected) abdominal aortic aneurysm (AAA) with irregular aneurysmal wall, eccentric mural thrombus, and surrounding periaortic inflammatory changes.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–9
Traumatic Abdominal Aortic Aneurysm
Traumatic Abdominal Aortic Aneurysm
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a focal saccular aneurysmal dilatation arising from the abdominal aorta with an irregular disrupted aortic wall, surrounding eccentric mural thrombus, and a patent central lumen following blunt abdominal trauma. |
Report Line
A focal saccular aneurysmal dilatation measuring approximately 4.2 × 3.9 cm is identified arising from the abdominal aorta. The lesion demonstrates an irregular disrupted aortic wall, eccentric mural thrombus, and a patent central lumen on Color Doppler examination. The imaging features, in the appropriate clinical setting, are consistent with a traumatic abdominal aortic aneurysm. No sonographic evidence of active extravasation, rupture, or periaortic hematoma is identified.
Impression
Traumatic abdominal aortic aneurysm with focal saccular dilatation and eccentric mural thrombus.
No sonographic evidence of rupture.
Go To Table
No sonographic evidence of rupture.
CASE–10
Pseudoaneurysm (False Aneurysm) of the Abdominal Aorta
Pseudoaneurysm (False Aneurysm) of the Abdominal Aorta
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a saccular pseudoaneurysm arising from the abdominal aorta through a narrow neck, with turbulent bidirectional blood flow within the aneurysmal sac (yin-yang appearance on Color Doppler). |
Report Line
A 4.1 × 3.8 cm saccular pseudoaneurysm is identified arising from the abdominal aorta through a narrow communicating neck. Color Doppler demonstrates turbulent bidirectional ("yin-yang") flow within the aneurysmal sac, with a characteristic to-and-fro waveform at the neck on spectral Doppler. The pseudoaneurysm is contained by surrounding soft tissues without sonographic evidence of free rupture or retroperitoneal hematoma.
Impression
Pseudoaneurysm (false aneurysm) of the abdominal aorta arising through a narrow neck, demonstrating characteristic Color and Spectral Doppler findings.
No sonographic evidence of free rupture.
Go To Table
No sonographic evidence of free rupture.
CASE–11
Intact Abdominal Aortic Aneurysm (AAA)
Intact Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Transverse sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus surrounding a patent central lumen. The aneurysmal wall is intact without evidence of leakage or rupture. |
Report Line
Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 4.9 × 4.6 cm is noted, containing eccentric mural thrombus with a patent central lumen. The aneurysmal wall appears intact. No sonographic evidence of periaortic hematoma, retroperitoneal fluid collection, leakage, or rupture is identified.
Impression
Intact infrarenal abdominal aortic aneurysm (AAA) with eccentric mural thrombus.
No sonographic evidence of aneurysm leakage or rupture.
Go To Table
No sonographic evidence of aneurysm leakage or rupture.
CASE–12
Leaking Abdominal Aortic Aneurysm (AAA)
Leaking Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus, adjacent periaortic hypoechoic hematoma, and focal discontinuity of the aneurysmal wall, suggestive of a contained leak. |
Report Line
Fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 5.8 × 5.4 cm is identified with eccentric mural thrombus and a patent central lumen. A focal defect in the aneurysmal wall is associated with an adjacent periaortic hypoechoic collection/contained hematoma, consistent with a contained leaking abdominal aortic aneurysm. No free intraperitoneal fluid is identified on this examination.
Impression
Leaking infrarenal abdominal aortic aneurysm (AAA) with contained periaortic hematoma, highly suspicious for a contained rupture.
Urgent vascular surgical intervention is recommended.
Go To Table
Urgent vascular surgical intervention is recommended.
CASE–13
Ruptured Abdominal Aortic Aneurysm (AAA)
Ruptured Abdominal Aortic Aneurysm (AAA)
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| Abdominal aortic ultrasound. Longitudinal sonographic image demonstrates a large fusiform infrarenal abdominal aortic aneurysm with eccentric mural thrombus, disruption of the aneurysmal wall, and a large periaortic/retroperitoneal hematoma, consistent with aneurysm rupture. |
Report Line
Large fusiform aneurysmal dilatation of the infrarenal abdominal aorta measuring approximately 6.8 × 6.2 cm is identified with eccentric mural thrombus and a patent residual lumen. There is focal disruption of the aneurysmal wall with an extensive periaortic and retroperitoneal hematoma, consistent with a ruptured abdominal aortic aneurysm. Associated free intraperitoneal fluid is noted, highly suggestive of active hemorrhage.
Impression
Ruptured infrarenal abdominal aortic aneurysm (AAA) with extensive retroperitoneal hematoma and sonographic evidence of active hemorrhage.
This is a life-threatening vascular emergency requiring immediate surgical intervention.
Go To Table
This is a life-threatening vascular emergency requiring immediate surgical intervention.
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