ULTRASOUND OF THE ABDOMINAL AORTA

Course overview

"The timely diagnosis of an abdominal aortic aneurysm (AAA) is one the most important and time-critical applications of bedside ultrasound. Rupture of an AAA is the 13th leading cause of death in the United States, yet early detection and repair could prevent the majority of these deaths. To put it into specific terms, mortality from untreated AAA is 100% compared to mortality of 1%-6% following elective repair, with subsequent lifespans similar to matched controls. When these statistics are considered, it is clear why detecting AAA quickly and accurately cannot be overemphasized as a malpractice risk reduction initiative. In this activity, we provide an overview of the epidemiology, clinical presentation, and physical exam findings related to AAA. We discuss the diagnostic evaluation for AAA and propose a clinical approach for patients presenting with AAA; we focus on the sonographic approach (i.e., techniques for imaging the abdominal aorta and the sonographic pathology of the abdominal aorta). After completing this activity, practitioners should be able to: create a standard approach to the evaluation of elderly patients that includes an analysis of risk factors for AAA in order to help prioritize AAA on the list of differential diagnoses; identify high-risk patients who should have a bedside ultrasound exam of their abdominal aorta as part of their Emergency Department evaluation; and consider surrounding structures when performing a bedside ultrasound that may confound the evaluation of the abdominal aorta."