June 2013

Structure impressing the right kidney

Clinical Info

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

Ultrasound Images & Clips

Structure impressing the right kidney in a patient with back pain

Longitudinal image of the right kidney with a mass impressing the lowerpole
Longitudinal image of the right kidney with a mass impressing the lowerpole
Another longitudinal image of the right kidney. The mass is inhomogeneous
Another longitudinal image of the right kidney. The mass is inhomogeneous
Transverse image of the same mass impressing the right kidney
Transverse image of the same mass impressing the right kidney
The mass displaces the vena cava anteriorly
The mass displaces the vena cava anteriorly
The mass is dorsal to the renal vessels and not vascularized. Can you guess what it is
The mass is dorsal to the renal vessels and not vascularized. Can you guess what it is
Transverse image of the aorta showing an aneurysm
Transverse image of the aorta showing an aneurysm
Transverse image showing the hematoma arising from the aneurysm.The patient had a ruptured abdominal aneurysm with a large retroperitoneal hematoma impressing the kidney
Transverse image showing the hematoma arising from the aneurysm.The patient had a ruptured abdominal aneurysm with a large retroperitoneal hematoma impressing the kidney
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
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
This hematoma is also inhomogeneous and there is a perirenal effusion
This hematoma is also inhomogeneous and there is a perirenal effusion
In this case there is also a ruptured abdominal aortic aneurysm
In this case there is also a ruptured abdominal aortic aneurysm
Transvere image of the aneurysm.
The patient died immediately after the ultrasound examination
Transvere image of the aneurysm. The patient died immediately after the ultrasound examination

Conclusion

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.


Details

  • Sex: Female
  • Age: 56

Created with

  • Hitachi Ultrasound System