Answer to a Specific Clinical Question

Emergency medicine AAA assessment is a focused examination to answer a single clinical question: is an abdominal aortic aneurysm with a diameter greater than 3 cm present? (image bottom left. Click the image to see a larger version).

As in all areas of emergency medicine ultrasound, we ‘rule in’ pathology rather than rule it out. Having said this, if the entire aorta is clearly seen (as in the image bottom right), an AAA will not be present. Click the images to see larger versions.

The combination of an aneurysm on ultrasound, and an unstable or symptomatic patient, is enough to warrant an emergency vascular surgery opinion.

Learning bite

Always consider the scan in a clinical context.