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Emergency Medicine


Answer 2
  1. Abdominal CT scan. Although findings on plain radiography can suggest an aortic aneurysm, it is neither sensitive nor specific and should not be obtained. Aortic ultrasonography is an excellent study to detect the presence of an abdominal aortic aneurysm, but it is inadequate for the detection of rupture. Angiography is time- and labor-intensive and has no role in a patient with potential rupture. Because contrast only goes where blood flows, a near-normal-appearing lumen may be visualized in the setting of a contained rupture with thrombus. Abdominal magnetic resonance imaging will accurately define the vascular anatomy but can be very time-consuming. In most emergency settings, CT scan is readily available, quick, can be done without contrast, and is the initial imaging procedure of choice in the setting of possible aortic rupture.

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