Ultrasound Assessment of the Abdominal Aorta in the Acute Setting

The lifetime incidence of abdominal aortic aneurysm (AAA) is 8.9% in males and 2.2% in females, with the peak incidence occurring in males during their ninth decade of life. The main concern with AAA is rupture. Saccular aneurysms are localised and may occur on any surface of an otherwise normal appearing aorta. This chapter describes an effective examination which can be performed at the point-of-care (POC), to identify the presence or absence of an AAA. On ultrasound, an aneurysm appears as an abnormal dilatation of the artery. It also presents a brief on ultrasound appearances of open repair and endovascular aortic repair (EVAR) stent grafts. The absence of free abdominal fluid does not exclude acute AAA. If an AAA is detected in a patient in shock, it should be presumed to be ruptured or leaking until proven otherwise.