The diagnosis of aortic dissection by emergency medicine ultrasound

Common Iliac Artery Tortuosity Simulating Aortic Dissection on Focused Abdominal Ultrasound in the Emergency Department

“…ED ultrasound has proven to be a safe and useful diagnostic tool for evaluating patients with suspected ruptured abdominal aortic aneurysm, but the role of this procedure in case of suspected aortic dissection is less clear (4)(5)(6)(7). Strong evidence suggests the diagnostic accuracy of transesophageal echocardiography in an emergency setting, when performed by a well-trained Emergency …”

“…Its use is limited to the detection of pericardial effusion or tamponade and the detection of a proximal aortic dissection. The ultrasound equipment in our ED is not provided with transesophageal array, but the detection of an abdominal aorta with intimal flap in the lumen is almost always diagnostic of aortic dissection (7). A correct diagnosis of aortic dissection requires a thorough search, and is of the utmost importance because a delayed diagnosis can have dramatic consequences.…”

Emergency Sonography for the Elderly

“…Fojtik et al 40 reported five cases of aortic dissection in patients aged older than 60 years who presented with pain in the chest or abdomen, which was successfully diagnosed by emergency physicians using ES to search the abdominal and thoracic aorta for pathology.…”

Ultrasound in the surgical intensive care unit

“…Other studied or reported diagnostic and therapeutic applications for ultrasound that are relevant to an ICU population include: volumetric bladder ultrasound [79], evaluation for sternal and other fractures [14,80], ultrasound-guided inferior vena cava filter placement [14,81], diagnosis of venous thrombosis, thrombophlebitis and pseudoaneurysm [28,82], arthrocentesis [83], diagnosis of sinusitis [41 ], evaluation for hydronephrosis [44 ], assessment of arterial and venous flow [44 ], percutaneous nephrostomy tube placement [14], diagnosis of aortic dissection [84], and performance of ultrasound-guided nerve blocks [85,86]. Many diagnostic and interventional roles for ultrasound remain mostly the purview of the radiologist.…”