Incidental Finding of Asymptomatic Aortic Dissection

Abstract

Introduction Aortic dissection limited to the abdominal aorta is not common. This case report describes the role of duplex ultrasound in the diagnosis of asymptomatic dissection of the abdominal aorta. Case Report A 59-year-old man with hypertension and mild renal impairment was referred to the vascular laboratory for color ultrasound examination of the renal arteries to rule out renal arterial stenosis. The ultrasound examination revealed a nonsignificant (<60%) stenosis in the right renal artery and two thickened but patent left renal arteries; however, there was an incidental finding of dissection of the abdominal aorta arising from the level of the celiac trunk down into the iliac arteries. Magnetic resonance imaging of the thoracic and abdominal aorta was requested; contrast was not used in view of the patient's deteriorating renal function. The finding revealed no features to indicate dissection in the thoracic or abdominal aorta. In view of the discrepancy in findings, computed tomography aortogram was performed. Dissection of the abdominal aorta just distal to the origins of the renal arteries was seen. This case study details the high sensitivity of color ultrasound imaging in identifying abdominal aorta dissection. Conclusion Color duplex ultrasound may be operator dependent but it is a highly sensitive and cost effective modality for identifying abdominal aortic dissection.