Duplex ultrasound of the abdominal aorta--a neglected tool in aortic dissection

The use of duplex ultrasound for the diagnosis and assessment of abdominal aortic dissection and visceral arterial involvement is discussed. Ultrasound is simple and non-invasive and may be superior to aortography in diagnosis; it should be performed after ultrasound assessment of the aortic root. It also provides an effective means of follow-up evaluation if conservative treatment is employed. Three cases are discussed in whom there was no operative intervention. In one case, aortography failed to make a positive diagnosis of aortic dissection. The diagnosis was made by ultrasound in all three cases, one of whom was found subsequently to have Marfan's syndrome.