OBJECTIVE: The purpose of this study was to categorize the sonographic findings seen in patients with a ruptured abdominal aortic aneurysm (AAA) and to describe 3 previously undescribed sonographic findings. METHODS: From January 1997 to December 2003, we evaluated 388 consecutive patients with an AAA (transverse aortic diameter >30 mm). Among these patients, 29 had surgical or computed tomographic demonstration of aneurysm rupture. The remaining 359 were asymptomatic and had no evidence of AAA rupture at follow-up. RESULTS: Findings recognized among 29 positive cases included AAA deformation (n = 12), luminal thrombus inhomogeneity (n = 20), clear interruption of a luminal thrombus (n = 5), retroperitoneal hematoma (n = 22), and hemoperitoneum (n = 11). In addition, 3 previously unreported findings were noted: an intraluminal floating thrombus layer (n = 8), a parietal hypoechoic focus due to aneurysm wall interruption (n = 3), and a para-aortic hypoechoic area adjacent to the bleeding side (n = 4). Aside from AAA deformation and thrombus heterogeneity, no other signs were recognized among subjects with a nonruptured aneurysm. CONCLUSIONS: In the past, sonography has been used mainly to rapidly confirm aneurysm presence in the clinical setting of a patient with a suspected rupture. Instead, this retrospective series shows how this imaging technique can frequently identify several direct and indirect signs of aneurysm rupture itself. Moreover, 3 new indicators of AAA rupture have been observed.
OBJECTIVE: The purpose of this study was to categorize the sonographic findings seen in patients with a ruptured abdominal aortic aneurysm (AAA) and to describe 3 previously undescribed sonographic findings. METHODS: From January 1997 to December 2003, we evaluated 388 consecutive patients with an AAA (transverse aortic diameter >30 mm). Among these patients, 29 had surgical or computed tomographic demonstration of aneurysm rupture. The remaining 359 were asymptomatic and had no evidence of AAA rupture at follow-up. RESULTS: Findings recognized among 29 positive cases included AAA deformation (n = 12), luminal thrombus inhomogeneity (n = 20), clear interruption of a luminal thrombus (n = 5), retroperitoneal hematoma (n = 22), and hemoperitoneum (n = 11). In addition, 3 previously unreported findings were noted: an intraluminal floating thrombus layer (n = 8), a parietal hypoechoic focus due to aneurysm wall interruption (n = 3), and a para-aortic hypoechoic area adjacent to the bleeding side (n = 4). Aside from AAA deformation and thrombus heterogeneity, no other signs were recognized among subjects with a nonruptured aneurysm. CONCLUSIONS: In the past, sonography has been used mainly to rapidly confirm aneurysm presence in the clinical setting of a patient with a suspected rupture. Instead, this retrospective series shows how this imaging technique can frequently identify several direct and indirect signs of aneurysm rupture itself. Moreover, 3 new indicators of AAA rupture have been observed.
Authors: Andreas S Peters; Maani Hakimi; Philipp Erhart; Michael Keese; Thomas Schmitz-Rixen; Markus Wortmann; Moritz S Bischoff; Dittmar Böckler Journal: Langenbecks Arch Surg Date: 2016-04-07 Impact factor: 3.445
Authors: Igor Sazonov; Ashraf W Khir; Wisam S Hacham; Etienne Boileau; Jason M Carson; Raoul van Loon; Colin Ferguson; Perumal Nithiarasu Journal: Biomech Model Mechanobiol Date: 2017-02-21