Ultrasound Case 058


A 71 year old man presents with severe back pain and hypotension. You suspect AAA.

View 2
LITFL Top 100 Ultrasound 058 02 Ruptured AAA

Describe and interpret these scans

Image 1: Transverse view of the epigstrium sliding from xiphisternum to umbilicus. As the scan moves inferiorly the typical appearance of an abdominal aortic aneurysm with intraluminal thrombus becomes apparent. Outside the aorta is a large retroperitoneal haematoma.

Image 2: Transverse view just above umbilicus.

LITFL Top 100 Ultrasound 058 02 Ruptured AAA Key to Image 01-02
Key to Images 1 and 2


Ruptured abdominal aortic aneurysm with retroperitoneal haematoma

Retroperitoneal haematoma may be anterior to the aorta, to the left (usually) or the right. This patient had had pain for several hours and the large retroperitoneal haematoma has the characteristic heterogeneous appearance – bits of black, bits of grey, bits of white.



An Emergency physician based in Perth, Western Australia. Professionally my passion lies in integrating advanced diagnostic and procedural ultrasound into clinical assessment and management of the undifferentiated patient. Sharing hard fought knowledge with innovative educational techniques to ensure knowledge translation and dissemination is my goal. Family, wild coastlines, native forests, and tinkering in the shed fills the rest of my contented time. | SonoCPDUltrasound library | Top 100 | @thesonocave |

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