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