ResUS Pearl: US is Highly Sensitive in Diagnosing AAA

According to a recent meta-analysis, the pooled operating characteristics of ED bedside US for the detection of AAA were sensitivity 99% and specificity 98%.

• Up to 50% of AAA patients lack the classic triad of hypotension, back pain, and pulsatile abdominal mass.

• The sensitivity of abdominal palpation for AAA increases as the diameter of the AAA increases.

• With nearly 90% mortality, and causing about 9000 deaths per year, ruptured AAA represents an important diagnostic opportunity for the use of bedside ultrasound.

Figure 1 POCUS transverse orientation of ruptured AAA

                                

Figure 2 CT of same patient demonstrating a large false lumen

References

Rubano E, Mehta N, Caputo W, et al.Systematic Review: Emergency Department Bedside Ultrasonography for Diagnosing Suspected Abdominal Aortic Aneurysm. Acad Emerg Med. 2013


Submitted by: P Maher, MD