Identifying abdominal aortic dissections

Abdominal aortic aneurysm (AAA) ruptures claim the lives of half of their victims before they reach the hospital. However, ultrasound offers a non-invasive and cost-effective method for early diagnosis and monitoring. Understanding the anatomy, pathology, and bedside ultrasound technique for AAA screening is paramount in preventing fatalities.

Aortic or iliac artery dissections—often incidental findings during screening—pose significant risks if left undetected. Recognizing a dissection involves identifying tears in the intima, the innermost layer of the artery wall, which may obstruct blood flow and lead to severe complications, including a ruptured aorta.

Symptoms such as mild lower back numbness, shortness of breath, severe abdominal pain, and loss of consciousness may indicate an aortic dissection. Causes of dissection include weakened arterial walls due to aneurysm, hypertension, and arterial plaque.

Ultrasound imaging plays a pivotal role in identifying dissections. On ultrasound, a dissection appears as a bright line within the artery lumen, visible in both black-and-white and color images. Documenting peak systolic velocities on either side of the bright line in longitudinal view helps assess blood flow and determine the severity of the condition.

Moreover, it's crucial to evaluate the extent of the dissection, especially if it involves the aorta and iliac arteries. Treatment typically involves endografts or stents, which can also be utilized alongside AAA endograft surgery.

By honing your skills in identifying abdominal aortic dissections, you contribute significantly to preventive medicine and potentially save lives.

Ready to enhance your expertise in abdominal aortic aneurysm detection? Watch the full Ultrasound Masterclass: Abdominal Aortic Aneurysms course. With early detection and proper management, you can mitigate the risks associated with abdominal aortic dissections and improve patient outcomes.