Emory University School of Medicine
Emory University School of Medicine
Department of Emergency Medicine

Ultrasound section navigation

Department of Emergency Medicine

Lower Back & Abdominal Pain

This week’s ultrasound image is an abdominal aorta scan on a hypotensive 64-year-old male who presented with abdominal and back pain (Image 1).

Image 1

lowerbackpain1 

This image captures a transverse view of the abdominal aorta and raises concern for a luminal defect. Can you ID the anatomy and pathology? (Image 2)

Image 2

lowerbackpain2

CTA of the abdomen confirmed the presence of a fusiform aneurysm measuring 3.5 cm with a mural thrombus. Quick diagnosis allowed for appropriate management decisions and disposition to the ICU. 

Remember these simple things when performing an aorta scan:

  • The aorta is imaged using the curvilinear (abdominal) probe
  • Gentle pressure on the probe will help disperse bowel gas and facilitate aortic views
  • Obtain measurements of the aorta from outer wall to outer wall
  • 5 images should be obtained for a full scan:
    • Proximal aorta in cross section (indicator to the right)
    • Mid Aorta in cross section (indicator to the right)
    • Distal Aorta in cross section showing the bifurcation (indicator to the right)
    • Iliacs showing individual diameter measurements (indicator to the right)
    • One longitudinal view capturing the celiac trunk and SMA (indicator toward the head)