A 68 year old man is brought in by ambulance with severe lower back and lower limb pain and paralysis. Clinically he has lower limb ischaemia and you wonder about aortic dissection as the cause.
View 2 – Longitudinal
Describe and interpret these scans
Image 1: Transverse view abdominal aorta. There is a 42mm abdominal aortic aneurysm. No dissection flap is seen but there is echogenic material throughout the lumen.
Image 2: Longitudinal view abdominal aorta. The fusiform aneurysm is again seen. The echogenic thrombus filling the entire lumen can be seen to move with each systole.
Acute aortic thrombosis
Acute aortic thrombosis is rare and life threatening. It may be due to acute occlusion of an abdominal aortic aneurysm as in this case; in situ thrombosis of an atherosclerotic aorta; or the result of a large saddle embolus astride the aortic bifurcation.
Urgent revascularisation is essential however reperfusion injury and post-perfusion syndrome may also be catastrophic.