CASES 727-728-729: SUBCLINICAL ABDOMINAL AORTIC ANEURYSM, Dr PHAN THANH HẢI, Dr TRẦN MỘC HIỆP, MEDIC MEDICAL CENTER, HCMC, VIETNAM

 3 cases (1 female,  2 males ) with subclinical abdominal aortic aneurysm [AAA] were incidentally detected firstly by abdominal ultrasound, and confirmed later by MSCT. 

Surgery repaired abdominal aorta with Y tube silver graft and all of patients were well post-op.

Case one: 

A 61 year-old man with hematemesis, normal BP: 120/80 mmHg, but  gets hypogastric pain. AAA # 60x90 mm from renal artery level to iliac artery.

Case 02:

A 71 year- old woman with lordosis for a check-up,  BP :125/80 mmHg. AAA # 60X103 mm from renal artery level in risk of rupture, and iliac artery aneurysms.

Case 03:

A 78 year-old man with sleep trouble, BP :124/79 mmHg. AAA# 40x70 mm and iliac artery aneurysm.

DISCUSSIONS:

Elderly patients complaining of lumbago, lower limb weakness, erectile problems in males, or occasionally feeling of "a heart in the abdomen" may have a silent abdominal aortic aneurysm. 

In our facility, the annual incidence of subclinical abdominal aortic aneurysm is around 10%. Additionally, the AAA dissection may occur in 10% of those AAA.

In Vietnam, applying ultrasound first, POCUS in particular, may be useful in identifying the AAA (and then MSCT to confirm) that helps preventing the elderly patient's death. Sonologists should make it a practice to check for abdominal aortic aneurysms before concluding the ultrasound examination.

REFERENCE:

Nguyễn Thiện Hùng, Phan Thanh Hải et al (1998): Ultrasound for diagnosing abdominal aortic aneurysm and prognosis in 10 years, Journal of Medicine Practice of Medicine and Pharmacy Society in HCM City:3:pp 3-7.