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

Year 2019, Volume: 5 Issue: 4, 599 - 606, 04.07.2019

Suna Eraybar , Şule Akköse Aydın , Meral Leman Özkan Serhat Atmaca Yasemin Nennicioglu

https://doi.org/10.18621/eurj.402076

Cited By: 2

Abstract

Objective: Our study was carried out to investigate
the effects of focused ultrasound imaging which is performed 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 the complaints of abdominal
pain, side pain, chest pain, syncope, unexplained hypotension and under
suspicion of the abdominal aortic aneurysm, were included in the study. Bedside
ultrasound for abdominal aorta was done and diameter measurements of aorta
recorded in order to determine the presence of an abdominal aortic aneurysm or
to exclude the diagnosis.

Results: A total of 133
patients were included in the study. Eight patients were excluded from the
study because of 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%) were detected. 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, their computed tomography images were
obtained and their aortic diameters were found within normal limits. Further
imaging studies weren’t performed at the remaining 48 (38.4%) patients because
different prediagnosis was considered. 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 has a 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 emergency physicians should become routine for
using time and investigation numbers properly. 

Keywords

emergency department, abdominal aortic aneurysms, bedside ultrasound

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