Ultrasound Case of the Month
Case of the Month from December, 2016
Case #1: Submitted by Dr. Leytin
49 year old male with a past medical history of hypertension presents to the ED for sudden onset severe, lower abdominal pain that began this morning. He also complains of one episode of nausea and vomiting. He has been non-compliant with his medications. A bedside ultrasound was performed:
Case #2: Submitted by Dr. Boardman, Blackwood, and Liebmann
84 year old male with past medical history significant for hypertension presents with lower abdominal and back pain. He comes in after having a syncopal episode while sitting at home. He is hypotensive and diaphoretic on arrival. A bedside ultrasound was performed:
Aortic Imaging:
Ultrasound of the aorta can be performed easily when you are concerned about aortic pathology. Start with the curvilinear, high penetration/low frequency probe in the subxiphoid region with the probe marker to the right of the patient. The aorta will be seen in cross section superficial to the thoracic spine. Measure the aorta at the level of the celiac trunk, the SMA, the mid aorta, and at the bifurcation into the iliacs, which is typically above the umbilicus. The abdominal aorta should be measured outer to outer wall, and should be less than 3cm, and the iliacs should be less than 1.5 cm. Consider also rotating the probe to point to the patients head to evaluate the aorta in long axis which is more ideal for identifying saccular aneurysms.
For more information on Aorta US:
5 Minute Sono Aortic Dissection
Resident Reviwer: Dr. Chana Rich
Faculty Reviewer: Dr. Kristin Dwyer