CASE REPORT

Ultrasound by emergency physicians to detect abdominal aortic aneurysms: a UK case series

A Walker¹, J Brenchley², J P Sloan¹, M Lalanda¹ and H Venables³

¹ Department of Emergency Medicine, Leeds General Infirmary, Leeds, UK
² Department of Emergency Medicine, Barnsley District General Hospital, Barnsley, UK
³ School of Healthcare Studies, University of Leeds, Leeds, UK

Correspondence to:
Correspondence to:
Dr J Brenchley
Department of Emergency Medicine, Barnsley District General Hospital, Gawber Road, Barnsley S75 2EP, UK; jane.brenchley{at}bdgh-tr.trent.nhs.uk

Early identification of abdominal aortic aneurysms in some patients can be difficult and the diagnosis is missed in up to 30% of patients. Ultrasound cannot be used to identify a leak, but the presence of an aneurysm in an unstable patient is conclusive. With minimal training emergency physicians can easily identify the aorta and thus in the early phase of resuscitation an aneurysm can be confidently excluded. The purpose of the examination is not to delineate the extent of the aneurysm, but to identify those patients that will need emergency surgery. A series of patients presented to the department in an unstable condition with equivocal abdominal signs. An ultrasound scan in the resuscitation room by members of the emergency department revealed an aneurysm, which was enough to convince the vascular surgeons to take the patient straight to theatre with good results. In patients who are stable, computed tomography will continue to be used to evaluate the extent of the aneurysm and identify a leak.

Keywords: aneurysm; ultrasound

Abbreviations: AAA, abdominal aortic aneurysms; FAST, focused assessment with sonography in trauma

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    What's this?

This article has been cited by other articles:

• Gaughan, M, McIntosh, D, Brown, A, Laws, D (2009). Emergency abdominal aortic aneurysm presenting without haemodynamic shock is associated with misdiagnosis and delay in appropriate clinical management. Emerg. Med. J. 26: 334-339 [Abstract] [Full Text]  
• Dent, B, Kendall, R J, Boyle, A A, Atkinson, P R T (2007). Emergency ultrasound of the abdominal aorta by UK emergency physicians: a prospective cohort study. Emerg. Med. J. 24: 547-549 [Abstract] [Full Text]  
• Mahmood, F, Ahsan, F, Hockey, M (2005). Ruptured abdominal aortic aneurysm presenting as buttock pain. Emerg. Med. J. 22: 453-454 [Abstract] [Full Text]