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Case of the Month

June 2013

Patient Data: Female patient 56 year old

Clinical Info: Patient was referred for an ultrasound examination to exclude a urolithiasis because of pain in her back


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Longitudinal image of the right kidney with a mass impressing the lowerpole


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Another longitudinal image of the right kidney. The mass is inhomogeneous


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Transverse image of the same mass impressing the right kidney


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The mass displaces the vena cava anteriorly


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The mass is dorsal to the renal vessels and not vascularized. Can you guess what it is


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Transverse image of the aorta showing an aneurysm


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Transverse image showing the hematoma arising from the aneurysm.The patient had a ruptured abdominal aneurysm with a large retroperitoneal hematoma impressing the kidney


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Not all patients are just as lucky as in the previuos case. This was a similar looking image of a comatous patient of over 80 years old


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This hematoma is also inhomogeneous and there is a perirenal effusion


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In this case there is also a ruptured abdominal aortic aneurysm


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Transvere image of the aneurysm. The patient died immediately after the ultrasound examination

Although many patients with a ruptured abdominal aneurysm present with classical clininical symptoms including hypotension the clinical presentation can be less classical and one should always be aware of this possibility. A retroperitoneal hematoma with an aortic aneurysm is always suspicious for a leaking or ruptured aortic aneurysm.

For more cases of ruptured and non ruptured aortic aneurysms see

Copyright © Dr. T.S.A. Geertsma, Ziekenhuis Gelderse Vallei, Ede, The Netherlands. All rights reserved.

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