A review of the plain abdominal radiograph in acute rupture of abdominal aortic aneurysms.
The abdominal radiographs of 31 patients, each with a surgically proven rupture of an abdominal aortic aneurysm, were reviewed retrospectively. The following changes were noted: calcification of the aneurysm in 65%, a soft tissue mass in 67%, complete loss of one or both psoas outlines in 75%, complete loss of one or both renal outlines in 78%, renal displacement in 25%, and properitoneal flank stripe changes in 19%. Unilateral loss of the subperitoneal fat line occurred in one patient. Loss of the psoas, renal and properitoneal-fat lines are indicative of a large retroperitoneal fluid collection. In patients with acute or subacute intra-abdominal symptomatology, it is important to examine the radiograph with specific attention directed at these retroperitoneal fat planes. The diagnosis of a ruptured aneurysm may be made in 90% of patients, particularly in the presence of a calcific aortic rim.
D000208:Acute Disease; D000368:Aged; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging; D001018:Aortic Diseases / Q000000981:diagnostic imaging; D001019:Aortic Rupture / Q000000981:diagnostic imaging*; D002114:Calcinosis / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies