June 2013

Structure impressing the right kidney

Bookmark

Clinical information

Patient was referred for an ultrasound examination to exclude a urolithiasis because of pain in her back

Ultrasound Images & Clips

Structure impressing the right kidney in a patient with back pain

Longitudinal image of the right kidney with a mass impressing the lowerpole

Another longitudinal image of the right kidney. The mass is inhomogeneous

Transverse image of the same mass impressing the right kidney

The mass displaces the vena cava anteriorly

The mass is dorsal to the renal vessels and not vascularized. Can you guess what it is

Transverse image of the aorta showing an aneurysm

Transverse image showing the hematoma arising from the aneurysm.The patient had a ruptured abdominal aneurysme with a large retroperitoneal hematoma impressing the kidney

Not all patient are just as lucky as in the previuos case. This was a similar looking image of a comatous patient of over 80 years old

This hematoma is also inhomogeneous and there is a perirenal effusion

In this case ther is also ruptured abdominal aortic aneurysm

Transvere image of the aneurysm. The patient died immediately after the ultrasound examination

Conclusion

Although many patients with a ruptured abdominal aneurysm present with classical clininical symptoms including hypotension the clinical presentation can be less classical and one should always be aware of this possibility. A retroperitoneal hematoma with an aortic aneurysm is always suspicious for a leaking or ruptured aortic aneurysm.

Details

Sex: Female
Age: 56

Created with

Fujifilm Ultrasound System

Browse through our ultrasound product portfolio

Looking for MSK Ultrasound Education? Visit Sonoskills.com

Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

More Cases from Taco Geertsma

[{"listLocation":"abdomen-and-retroperitoneum","icon":"001-abdomen-white.svg","header":"Abdomen and retroperitoneum","id":63},{"listLocation":"urinary-tract-and-male-reproductive-system","icon":"002-urinary-tract-white.svg","header":"Urinary Tract and male reproductive system","id":64},{"listLocation":"gynaecology","icon":"003-gynaecology-white.svg","header":"Gynaecology","id":65},{"listLocation":"head-and-neck","icon":"004-head-neck-white.svg","header":"Head and Neck","id":66},{"listLocation":"breast-and-axilla","icon":"005-breast-white.svg","header":"Breast and Axilla","id":67},{"listLocation":"musculo-skeletal-joints-and-tendons","icon":"006-msk-joints-white.svg","header":"Musculoskeletal Joints and Tendons","id":68},{"listLocation":"musculo-skeletal-bone-muscle-nerves-and-other-soft-tissues","icon":"007-msk-bones-white.svg","header":"Musculoskeletal, bone, muscle, nerves and other soft tissues","id":69},{"listLocation":"thorax","icon":"008-thorax-white.svg","header":"Thorax","id":70},{"listLocation":"pediatrics","icon":"009-pediatrics-white.svg","header":"Pediatrics","id":71},{"listLocation":"peripheral-vessels","icon":"010-peripheral-vessels-white.svg","header":"Peripheral vessels","id":72}]