Abdominal Vasculature - Part 6

Question 1

Ruptured aneurysm

Answer 1

Tear in all three layers of the aortic wall with leakage of blood

Question 2

What is the risk of a ruptured aneurysm within 5 years? (5cm, 6cm, 7cm)

Answer 2

5cm = 5%
6cm = 16%
7cm = 75%

Question 3

What are the clinical findings of a ruptured aneurysm? (5)

Answer 3

1. Severe abdominal pain
2. Severe groin pain
3. Hypotension
4. Loss of consciousness
5. Hypovolemic shock

Question 4

What is the US appearance of a ruptured aneurysm? (5)

Answer 4

1. Normal aortic size
2. Aneurysm may still be visualized
3. Asymmetric or unilateral paraaortic hypo echoic mass
4. “Veil appearance” over the aorta and surrounding
   structures
5. Free fluid in the peritoneal cavities

Question 5

What are 2 differential diagnosis of a ruptured aneurysm?

Answer 5

1. Lymphadenopathy
2. Chronic intraluminal
   thrombus

Question 6

What causes a AV fistula? (5)

Answer 6

1. Trauma
2. Congenital
3. Surgery
4. Inflammation
5. Neoplasm

Question 7

What are the clinical findings for an AV fistula? (4)

Answer 7

1. Presence of a bruit or “thrill”
2. Lower back or abdominal pain
3. Edema
4. Hypertension

Question 8

What is the US appearance for an AV fistula? (4)

Answer 8

1. Pulsatile flow within the vein
2. Increase in arterial flow proximal to site of
   shunting
3. Decrease in arterial flow distal to site of shunting 4. Turbulent waveform with high velocities in both the artery and the vein

Question 9

What are 2 differential diagnosis for an AV fistula?

Answer 9

1. Tortuous vessel

2. Stenotic vessel

Question 10

What is an infiltrating neoplasm of the IVC caused by?

Answer 10

Renal carcinoma

- most common cause

Question 11

What are the clinical findings of an infiltrating neoplasm of the IVC? (2)

Answer 11

1. Asymptomatic

2. Edema

Question 12

What is the US appearance of an infiltrating neoplasm of the IVC?

Answer 12

Intraluminal medium-level to low-level echoes

Question 13

What are 3 differential diagnosis of an infiltrating neoplasm of the IVC?

Answer 13

1. Venous thrombosis
2. Primary caval tumour
3. Technical error

Question 14

What is the most common cause of a primary caval neoplasm of the IVC?

Answer 14

Leiomyosarcoma

Question 15

What are the clinical findings of a primary caval neoplasm of the IVC? (2)

Answer 15

1. Asymptomatic

2. Edema

Question 16

What is the US appearance of a primary caval neoplasm of the IVC?

Answer 16

Intraluminal medium-level to low-level echoes

Question 17

What are the 3 differential diagnosis of a primary caval neoplasm of the IVC?

Answer 17

1. Infiltrating tumour
2. Venous thrombosis
3. Technical error

Question 18

What are the causes of thrombosis of the IVC? (5)

Answer 18

1. Extension of thrombus from femoral
   - most common
2. iliac
3. Renal
4. Hepatic
5. Gonadal veins

Question 19

What are the clinical findings of the thrombosis of the IVC? (4)

Answer 19

1. Asymptomatic
2. Edema
3. Pulmonary embolism
4. History of lower
   extremity DVT

Question 20

What is the US appearance of thrombosis of the IVC? (4)

Answer 20

1. Vessel enlargement
2. Intraluminal medium-level to
   low-level echoes
3. May result in complete or
   partial occlusion
4. Spectral analysis may demonstrate continuous nonphasic flow

Question 21

What are 3 differential diagnosis for thrombosis of the IVC?

Answer 21

1. Infiltrating tumour
2. Primary caval tumour
3. Technical error

Question 22

fusiform aneurysm is best described as…

Answer 22

A uniform dilatation of the arterial walls

Question 23

The presence of a palpable “thrill” within an artery is suspicious for a(n):?

Answer 23

Arteriovenous fistula

Question 24

The contour of a mycotic aneurysm is most commonly described as what shape?

Answer 24

Saccular shaped

Question 25

What artery gives rise to the gastroepiploic artery?

Answer 25

Splenic artery

Question 26

What condition most commonly coexists with a popliteal aneurysm?

Answer 26

Abdominal aortic aneurysm

Question 27

Development of an arteriovenous fistula may be caused by:

Answer 27

Neoplasm

Question 28

An infiltrating neoplasm within the IVC most commonly originates from which structures?

Answer 28

Kidney

Question 29

Dilatation of an artery caused by damage to one or more layers of the arterial wall describes a(n):

Answer 29

Pseudoaneurysm

Question 30

Patients with Marfan syndrome have a predisposing risk factor for developing a(n):

Answer 30

Abdominal aortic aneurysm

Question 31

Which vascular structure is most commonly mistaken as a dilated pancreatic duct?

Answer 31

Splenic artery

Question 32

A dilatation of an artery when compared with a more proximal segment describes what abnormalitity?

Answer 32

Saccular aneurysm