An 82-year-old female presented to the Emergency Department with complaint of a pulsatile abdominal mass. She mentioned that the pulsatile mass had been there for several years. She never went to a clinician to be examined prior to this visit. On ultrasound exam a fusiform abdominal aortic aneurysm was seen in the mid abdominal aorta.

What is the structure marked with the yellow arrow?

A. False lumen
B. Dacron graft
C. Thrombus

Image courtesy of UltrasoundCases.info owned by SonoSkills.

The arrow is pointing to a thrombus.

Explanation

75% of large abdominal aortic aneurysms have some form of thrombus within them. Thrombus formation has also been associated with an increase in size of the aneurysm. When measuring the diameter of the aneurysm, include the thrombus within the measurement if present within the most dilated region of the aneurysm.

References

https://doi.org/10.1148/radiol.2020191723

https://doi.org/10.1038/s41598-018-31637-6

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