Presentation
Fall from standing. Unclear whether mechanical or syncopal in etiology.
Patient Data
There is dilatation of the ascending aorta, aortic arch, and descending thoracic aorta. The patient is status post bifurcated aortic stent-graft.
There is a large, bilobed low density fluid collection which surrounds the bypass graft at the level of the mid/distal aorta and the iliac arteries to the level of the native common iliac arteries. The sac measures 18.4 x 11.5 x 14.3 cm. There are areas (1, 2) of hyperdense attenuation within the aneurysmal sac.
Other findings include extensive calcified pleural plaques bilaterally (suggestive of asbestosis-related changes), right-sided bowel-containing direct inguinal hernia, and extensive colonic diverticulosis.
Case Discussion
This is a case of a large, bilobed abdominal aortic aneurysm which was found following a CT chest, abdomen, and pelvis for trauma. The areas of hyperdense material within the dependent portion of aneurysm sac were concerning for recent hemorrhage. The patient was managed conservatively given his age and comorbidities.
Co-author:
Christopher Talone
Christine Cooley, MD
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