Related Experiment Video
Updated: May 21, 2026

An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta
Published on: September 8, 2023
Pulsatile abdominal mass is not always leaking aneurysm!
Syed Viqar Ahmed1, Philip Anthony McMillan, Chaminda Jayawarna
1Department of Acute Medicine, Stepping Hill Hospital, Stockport, Cheshire, UK. syedviqarahmed@hotmail.com
Abstract:
An 80-year-old male, who presented with a history of unprovoked collapse, was found to have a visible pulsation in the central upper abdomen, which disappeared on raising his arms above his shoulder ('head and shoulder' technique). There was no tenderness noted over the pulsation. He had a ventricular demand inhibited pacemaker inserted 3 weeks ago for a significant bradycardia with atrial fibrillation. His ECG showed heart rate of 32 bpm with underlying atrial fibrillation. No pacing spikes noted. His chest x-ray confirmed displacement of pacing lead into the right subclavian vein. It caused stimulation of phrenic nerve resulting in rhythmical diaphragmatic contraction. He later had his pacemaker re-inserted with no more collapses.
Related Concept Videos
Aneurysm I: Introduction
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aneurysm III: Interprofessional Care
Assessment of the Abdomen I: Inspection and Auscultation
The abdominal examination is a cornerstone of clinical medicine, serving as a critical tool in diagnosing various gastrointestinal (GI) diseases. It involves a systematic approach that includes inspection and auscultation, each with distinct yet complementary roles in assessing the abdomen. This article will delve into these two primary methods healthcare professionals use to examine the abdomen.
Inspection of the Abdomen
The first step in any abdominal examination is inspection.
Appendicitis
Assessment of the Abdomen III: Palpation