Abdominal Aorta aneurysm (AAA) screening

A 67–year–old male underwent an abdominal aorta aneurysm (AAA) screening ultrasound examat the outpatient clinic. He had a history of smoking one pack of cigarettes for the past 40years. He was also a known hypertensive. There was no known family history of AAA. Thefollowing image was obtained in the transverse view at the level of […]

A 67yearold male underwent an abdominal aorta aneurysm (AAA) screening ultrasound exam
at the outpatient clinic. He had a history of smoking one pack of cigarettes for the past 40
years. He was also a known hypertensive. There was no known family history of AAA. The
following image was obtained in the transverse view at the level of maximal dilatation of his
lower abdominal aorta. Two measurements were performed. What is the diameter of the
aneurysm?

  1. 1.64 cm
  2. 3.45 cm
  3. None of the above

Explanation:

The ultrasound image shows a transverse view of the lower abdominal aorta. The measurement should always be performed by placing the measurement calipers from outer wall to outer wall of the abdominal aorta. If a thrombus is present, include the thrombus also in the measurement. In this example, the AAA diameter is 3.45 cm.

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Explanation: 
Intrauterine contraceptive devices are quite effective in preventing intrauterine pregnancy. Fewer than
1-2% of women with a copper or hormonal IUD get pregnant every year. Ultrasound is a great imaging
modality to localize an IUD. In this example the pregnancy occurred because the IUD got displaced and
slipped into the cervical canal. Seek proper medical care to manage this condition. Gentle removal of the
IUD would be necessary. If the pregnancy occurred with an older IUD in the uterine cavity it may lead to
a spontaneous abortion. Transvaginal ultrasound may be needed to visualize the IUD clearly.

Figure 1. Observe direction of blood flow (red arrow) during diastole from the left atrium into the left ventricle.

Figure – Normal location of an IUD in the uterine cavity in a non-pregnant patient.

References
doi: 10.1016/j.contraception.2014.01.002
doi: 10.1016/j.contraception.2011.06.010
doi.org/10.1007/s13089-011-0068-1

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