The role of ultrasound imaging at detecting aortic aneurysm in emergency department

Abstract

Objective: Our study was carried out to investigate the effects of focused ultrasound imaging which isperformed by emergency physicians in diagnosis and duration of treatment of abdominal aortic aneurysm.Methods: The patients over 50 years; who applied to Uludağ University Emergency Department with thecomplaints of abdominal pain, side pain, chest pain, syncope, unexplained hypotension and under suspicion ofthe abdominal aortic aneurysm, were included in the study. Bedside ultrasound for abdominal aorta was doneand diameter measurements of aorta recorded in order to determine the presence of an abdominal aorticaneurysm or to exclude the diagnosis.Results: A total of 133 patients were included in the study. Eight patients were excluded from the study becauseof inadequate bedside US imaging. The aortic diameter was measured as ≥ 3 cm in the 54 (43.2%) patients.The aortic diameter was found more than 5 cm in 8 (6.4%) patients. After ultrasonographic investigations,aneurysm rupture (n = 5; 4%), aortic dissction (n = 13; 10.4%) and aortic aneurysm (n =36; 28.8%) weredetected. The diagnosis was confirmed with computed tomography in all patients who had aortic pathology.Because of the continuance of clinic suspects in the patients whose aortic diameters were less than 3 cm, theircomputed tomography images were obtained and their aortic diameters were found within normal limits. Furtherimaging studies weren’t performed at the remaining 48 (38.4%) patients because different prediagnosis wasconsidered. Emergency ultrasound had a sensitivity of 100% (95% CI: 87-100), a specificity of 91% (95% CI:90.8-99.8).Conclusions: The diagnosis of abdominal aortic aneurysms is omitted 30% in emergency departments. It hasa high morbidity and mortality if the diagnosis is skipped. In the presence of aortic aneurysm suspicion,evaluation of aortic diameter by bedside ultrasound is diagnostic. Bedside ultrasound evaluation by emergencyphysicians should become routine for using time and investigation numbers properly.