Key result
Point-of-care ultrasound using a pocket-sized device successfully identified an 8-cm dissecting abdominal aortic aneurysm in a 78-year-old man in a low-resource emergency department.
Why the study?
The role of pocket-sized point-of-care ultrasound for diagnosing abdominal aortic aneurysm in low-resource settings remains less explored.
Case Report (n=1)
No
Pocket-sized point-of-care ultrasound can be a critical tool for the early detection of life-threatening conditions like ruptured abdominal aortic aneurysms in low-resource emergency departments lacking standard imaging equipment.
Pocket-sized ultrasound enabled suspected ruptured AAA diagnosis in low-resource care; leaves open questions on diagnostic accuracy and broader applicability.
BACKGROUND: Abdominal aortic aneurysm (AAA) is a life-threatening condition characterized by the weakening and dilation of the abdominal aorta. AAA primarily affects men, smokers, and the elderly, with rupture being a fatal complication. While point-of-care ultrasound (POCUS) is valuable in diagnosing AAA, the role of using pocket-sized ultrasound in a low resource setting remains less explored. This case report presents a unique instance of a suspected ruptured AAA diagnosed using pocket-sized ultrasound in an emergency department (ED) situated in a low resource setting where ultrasound machines are absent, and emergency physicians lack proficiency in ultrasound usage. CASE PRESENTATION: A 78-year-old man with a history of hypertension and bladder cancer presented to the ED with suprapubic pain. Initial evaluation showed no concerning findings. However, the next day, he collapsed, became unconscious, and experienced a cardiac arrest. Despite resuscitation efforts, the patient's condition deteriorated. POCUS revealed an 8-cm dilated abdominal aorta with an intimal flap, indicative of a dissecting AAA and a substrate for AAA rupture. Unfortunately, the patient died despite resuscitation efforts. CONCLUSION: This case highlights the importance of considering AAA in patients with risk factors and abdominal pain in a low resource setting. POCUS using a pocket-sized ultrasound can aid in early AAA detection, potentially preventing rupture through preemptive vascular intervention. Emergency departments should prioritize ultrasound availability, and emergency physicians should be proficient in its use.
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Alasasfeh et al. (2024) conducted a case report in Ruptured abdominal aortic aneurysm (n=1). Pocket-sized ultrasound (POCUS) was evaluated on Diagnosis of ruptured abdominal aortic aneurysm. Point-of-care ultrasound using a pocket-sized device successfully identified an 8-cm dissecting abdominal aortic aneurysm in a 78-year-old man in a low-resource emergency department.
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