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Research Paper | Radiological Sciences | India | Volume 8 Issue 9, September 2019 | Rating: 7 / 10
Role of Imaging in Aortic Aneurysm with Rupture
Dr Jayaram Paruvada | Dr Sugguna Maheeja
Abstract: OBJECTIVES: To evaluate the role of imaging in a patient presenting with acute chest & abdomen pain, unimpressive back pain who are heamodynamically unstable to ensure early diagnosis & treatment. Materials & Methods: All patients who came to Department of Radio diagnosis with chief complaints of severe abdominal pain, fever, vomitings, hypotension and pulsatile abdominal mass etc & positive blood cultures, clinical signs of infection (leukocytosis, fever, an elevated C-reactive protein [CRP] concentration), and radiologic findings typical of AA. Ultrasound is the initial imaging modality of choice, as it is not associated with radiation hazards encountered wt x-rays/CT. CECT is the main diagnostic modality to detect aneurysms. MRI used in some cases. Graft infection and aorto-enteric fistulas were excluded. Results: 10 cases presented with severe abdominal pain. CECT showing multi lobulated saccular outpouching from abdominal aorta with with adjacent retroperitoneal para-aortic collection with air pockets. Contrast shows extravastion of contrast from the saccular aneurysm into retroperitoneal collection with hematoma. 35 year male patient, IV drug abuser Patient present with acute abdominal pain. CT shows ascending aorta dilatation (5cm) with saccular outpouching. 52y old male patient, post CABG incidentally identified ascending & arch of aorta dilatation with partial eccentric thrombus & adjacent soft tissue stranding and reactive lymphadenopathy. 4 cases presented with severe chest pain radiating to abdomen shows hematoma noted adjacent to thoracic aorta. 24y old woman presented with fever, right loin pain & hypertension. Plain CT shows no significant abnormality. On CT angiography shows abdominal aorta distal to renal vessels shows aneurysm with near complete occlusion by thrombus. 25y old pregnant woman known case of infective endocarditis came with chest and abdominal pain. CT shows a long segment aortic aneurysm extending from thoracic aorta extending upto abdominal aorta proximal to renal vessels. All results were correlated with surgical findings. Conclusion: Misdiagnosis and treatment of aortic aneurysms as low back pain, co-existing connective-tissue disease such as systemic lupus erythematosus and rheumatoid arthritis are risk factors for aneurysm-related death. Imaging is the modality of choice to diagnose aortic aneurysms for early management & prognosis evaluation. USG & CT are being used. Endovascular repair should be considered as an alternative option to the open repair of aortic aneurysms.
Keywords: Endovascular repair, aorto-enteric fistulas
Edition: Volume 8 Issue 9, September 2019,
Pages: 692 - 694