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Topics: Abdominal Trauma, Emergency Medicine

Abdominal Aorta Bifurcation – Anatomical Challenge

Case Study:

A 67-year-old male patient presented to the clinic for routine check up and was recommended a AAA screening exam. He is a known smoker for the past 40 years. He is also on antihypertensive agents. His blood pressure was 148/90 mm Hg. Rest of the vitals were within normal limits. His primary care physician performed a AAA screening exam. The following oblique view was obtained from the left side of the midline at the level of the lower abdominal aorta and bifurcation. Which blood vessel is the one highlighted in yellow?

  1. IVC
  2. Lower abdominal aorta
  3. Left common iliac artery
  4. Right common iliac artery
  5. We cannot determine which artery it is from the image and the information provided.

Answer: 4 — Right common iliac artery

Explanation:

From the image alone we cannot tell if it is the left or the right common iliac artery if we do not know which side the view was obtained from. Since, we know that the view was obtained from the left side of the abdomen, so the vessel closest to the skin surface will be the left common iliac artery and the one further away from the skin surface is the right common iliac artery and vice versa. The common iliac artery diameter of more than 1.5 cm would be considered aneurysmal.

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