File:Abdominal aortic aneurysm rupture (Radiopaedia 54179-60362 Axial C+ portal venous phase 12).jpg

Summary:

• Radiopaedia case ID: 54179
• Image ID: 31122774
• Image stack position: 12/52
• Plane projection: Axial
• Aux modality: C+ portal venous phase
• Study description: CT abdomen with contrast
• Modality: CT
• System: Vascular
• Findings: A large leaking fusiform abdominal aortic true aneurysm is seen. It starts at the L2-3 level. Its neck is 4 cm inferior to the renal arteries' origin. It extends to involve the right common iliac artery. It measures 10 cm in craniocaudal extension, axial dimension 10 x 11 cm. It has a partially thrombosed lumen; remaining patent lumen with axial dimension 6.8 x 8.3 cm. Maximum thrombus thickness 4.8 cm. Positive contrast leakage is seen through a mural defect measuring 1 cm, where contrast extravasation into aneurysmal thrombus and perianeurysmal hematoma measures 4 cm in thickness which extends to left perinephric hematoma. The left side of the retroperitoneal hematoma anterior to the left psoas muscle measures 7 cm in thickness. The posterior left pararenal space hematoma measures 3.5 cm with overall 24 cm craniocaudal dimension. Branches: the origin of the inferior mesenteric artery is occluded by soft thrombus. Preserved origin of the celiac, superior mesenteric and renal arteries. Size of the normal abdominal aorta: proximal to the aneurysm; infra-renal portion of the abdominal aorta, between the aneurysm neck and renal arteries axial dimension 3.1 x 3.2 cm. Above the renal artery measures 2.7 x 2.8 cm in axial dimension. Right common iliac artery is dilated measuring 5.5 x 5.3 cm, with partially thrombosed lumen, the patent lumen measures 2.3 x 2.6 cm. The proximal 5 cm of the left internal iliac artery is fusiform dilated measuring 2.4 cm. Left common iliac artery proximal part measures 2.0 x 1.8 cm and pre-bifurcation saccular aneurysm measures 2.7 cm. Patent external iliac arteries bilaterally with average caliber. Multiple hepatic and renal cysts are noted. Gallbladder stones.
• Published: 7th Jul 2017
• Source: https://radiopaedia.org/cases/abdominal-aortic-aneurysm-rupture-1
• Author: Mostafa El-Feky
• Permission: http://creativecommons.org/licenses/by-nc-sa/3.0/

Licensing:

CC-BY-NC-SA-3.0