E1091. Hidden in Plain View: The Variable Hidden Appearance of Abdominal Aortic Aneurysms on Plain Films: Correlation with Imaging Studies
  1. Hannah Sowalsky; New York Medical College
  2. Kanika Thapar; Westchester Medical Center
  3. Yehuda Herman; New York Medical College
  4. Ekramul Gofur; Westchester Medical Center
  5. Mayer Rubin; Westchester Medical Center
  6. Perry Gerard; Westchester Medical Center
  7. Jared Meshekow; Temple University, Lewis Katz School of Medicine
Thoracic and aortic aneurysms are commonly encountered pathology in the emergency room (ER) setting. The risk factors for abdominal aortic aneurysm (AAA) include age (>75 years), male gender, smoking history, prior vascular disease, hypertension, family history, and hypercholesterolemia. As ruptured aneurysms carry a high mortality rate, early diagnosis of asymptomatic aneurysms can help improve survival outcomes. While the imaging findings of aneurysms may be subtle using general radiography, it is imperative that radiologists be able to identify aneurysms correctly as obtaining advanced imaging such as CT/MRI may not occur in the ER setting and may result in delayed and/or suboptimal patient care.

Educational Goals / Teaching Points
Discuss and describe the variable appearance of abdominal aortic aneurysms on plain film radiographic studies; discuss the reasons for missed identification of these aneurysms and highlight improved methods to detect these early, and highlight the importance of the identification of aneurysms on general radiography and correlate it to cross-sectional imaging findings.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Pathophysiology of thoracic, abdominal, and visceral aneurysms. Dentify AAA early on plain films to plan follow-up imaging. Discuss the reasons why abdominal aortic aneurysms are commonly missed on plain films and demonstrate improved methods to detect these on plain film imaging.

Ruptured AAAs carry a high mortality rate. Early diagnosis of asymptomatic AAAs can help improve survival outcomes. Radiologists should pay particular attention when analyzing abdominal plain films for presence of aneurysms and make additional necessary recommendations to help aid clinicians in a timely diagnosis.