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Updated: May 22, 2026
07:12
An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta
Published on: September 8, 2023
[Abdominal aortic aneurysm: an uncommon presentation]
Lúcia Taborda1, Laurinda Pereira, Eurides Amona
1Serviços de Medicina Interna, de Oncologia Médica e de Radiologia, Hospital Nossa Srª do Rosário, Barreiro, Portugal.
Acta Medica Portuguesa
|April 25, 2012
Summary
A ruptured abdominal aortic aneurysm with an aorto-caval fistula is a rare, life-threatening emergency. This case highlights the critical need for rapid diagnosis and intervention in such vascular emergencies.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Cardiology
Background:
- Abdominal aortic aneurysms (AAAs) are often asymptomatic and found incidentally.
- Management involves surveillance and risk factor reduction, with surgery indicated for high rupture risk.
- Rupture typically occurs in the retroperitoneal space, but uncommon presentations like aorto-caval fistula demand urgent attention.
Observation:
- A 71-year-old male with hypertension, recent myocardial infarction, and smoking history presented with severe epigastric pain.
- Physical exam revealed differential blood pressure between upper and lower limbs and a pulsatile abdominal mass with a murmur.
- Computed Tomography and Doppler ultrasound confirmed a ruptured AAA with a mural thrombus and a high-output aorto-caval fistula.
Findings:
- The patient had a ruptured abdominal aortic aneurysm with a concurrent aorto-caval fistula.
- Diagnostic imaging was crucial for identifying this rare and rapidly fatal complication.
Implications:
- This case underscores the importance of prompt diagnosis and surgical intervention for ruptured AAAs, especially with unusual presentations.
- Timely recognition of aorto-caval fistulas is critical for improving patient outcomes in vascular emergencies.
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