A Tender Pulsatile Epigastric Mass is NOT Always an Abdominal Aortic Aneurysm: A Case Report and Review of Literature

Authors

  • Osama Moussa
  • Ahmad Al Samaraee
  • Rupsha Ray
  • Colin Nice
  • Vish Bhattacharya

DOI:

https://doi.org/10.3941/jrcr.v4i10.458

Keywords:

Pulsatile abdominal mass, Computed Tomography, CT Scan, Abdominal aortic aneurysm

Abstract

Of greatest concern in the assessment of a patient with a tender pulsatile abdominal mass is the possibility of a leaking or ruptured Abdominal Aortic Aneurysm (AAA). Other serious abdominal pathologies may demonstrate the same clinical signs but require entirely different treatments.  Even amongst patients with proven abdominal aortic aneurysms CT imaging findings may influence the timing and nature of surgery and provide useful prognostic information.   We present a case in which a large abdominal tender pulsatile mass was not aortic in origin. The patient had a significantly large tender congested liver associated with right side heart failure due to progressive tricuspid valve regurgitation. We have also discussed the differential diagnoses which may mimic abdominal aneurysms and discussed the role of imaging in resolving these problems.

Author Biographies

Osama Moussa

SHO in surgery , Department of General Surgery , Queen Elizabeth Hospital, Gateshead, UK , NE9 6SX

Ahmad Al Samaraee

Registrar in surgery , Department of General Surgery , Queen Elizabeth Hospital, Gateshead, UK , NE9 6SX

                                       

Rupsha Ray

SHO in surgery , Department of General Surgery , Queen Elizabeth Hospital, Gateshead, UK , NE9 6SX

Colin Nice

Consultant Radiologist , Department of Radiology , Queen Elizabeth Hospital, Gateshead, UK , NE9 6SX

Vish Bhattacharya

Consultant Surgeon , Department of Surgery , Queen Elizabeth Hospital, Gateshead, UK , NE9 6SX

Published

2010-09-26

Issue

Section

General Radiology