A pitfall in the echographic diagnosis of abdominal aortic aneurysm: when para-aortic lymph nodes are the trick

Submitted: January 4, 2023
Accepted: February 14, 2023
Published: February 22, 2023
Abstract Views: 684
PDF: 219
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Authors

The abdominal aortic aneurysm (AAA) is a potentially fatal asymptomatic disease. It progresses silently with clinical complications that, when they occur, constitute a very serious event, frequently resulting in the patient's exitus. As a result, early detection and treatment are critical because the right therapeutic strategy can halt the disease's natural progression. AAA is frequently discovered as an incidental finding during an abdominal ultrasound or a plain X-ray of the abdomen, which is required for other pathologies. The primary diagnostic tool for AAA identification is abdominal B-mode ultrasound. It is cheap, widely available, non-invasive, and has high diagnostic sensitivity. However, this diagnostic tool may fail in rare cases due to misleading anatomical findings. We present an unusual flaw in the echographic AAA evaluation that should be considered during the diagnostic work-up.

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Citations

Tan KHM, Salim S, Machin M, et al. Abdominal aortic aneurysm clinical practice guidelines: a methodological assessment using the AGREE II instrument. BMJ Open 2022;12:e056750.
Dalman RL. The 2019 update of the European abdominal aortic aneurysm guidelines. J Vasc Surg 2019;69:633-4.
Gao JP, Guo W. Mechanisms of abdominal aortic aneurysm progression: a review. Vasc Med 2022;27:88-96.
Zommorodi S, Leander K, Roy J, et al. Understanding abdominal aortic aneurysm epidemiology: socioeconomic position affects outcome. J Epidemiol Commun Health 2018;72:904-10.
Kent KC, Zwolak RM, Egorova NN, et al. Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals. J Vasc Surg 2010;52:539-48.
Stackelberg O, Wolk A, Eliasson K, et al. Lifestyle and risk of screening-detected abdominal aortic aneurysm in men. J Am Heart Assoc 2017;6:e004725.
Wanhainen A, Verzini F, Van Herzeele I, et al. Editor's choice - European society for vascular surgery (ESVS) 2019 clinical practice guidelines on the management of abdominal aorto-iliac artery aneurysms. Eur J Vasc Endovasc Surg 2019;57:8-93.
Iwakoshi S, Hirai T, Kichikawa K. Updates on ultrasonography imaging in abdominal aortic aneurysm. Ann Vasc Dis 2019;12:319-22.
Lema P, Kim J, St. James E. Overview of common errors and pitfalls to avoid in the acquisition and interpretation of ultrasound imaging of the abdominal aorta. J Vasc Diagn Interv 2017;5:41-6.
Hong H, Yang Y, Liu B, Cai W. Imaging of abdominal aortic aneurysm: the present and the future. Curr Vasc Pharmacol 2010;8:808-19.
Talwalkar PG, Sreenivas CG, Gulati A, Baxi H. Journey in guidelines for lipid management: from adult treatment panel (ATP)-I to ATP-III and what to expect in ATP-IV. Indian J Endocrinol Metab 2013;17:628-35.
Marsico F, Giugliano G, Ruggiero D, et al. Prevalence and severity of asymptomatic coronary and carotid artery disease in patients with abdominal aortic aneurysm. Angiology 2015;66:360-4.
Natale F, Capasso R, Casalino A, et al. Peripheral artery disease and abdominal aortic aneurysm: the forgotten diseases in COVID-19 pandemic. Results from an observational study on real-world management. Medicina 2021;57:672.
Wu H, Zhang L, Li M, et al. Systematic review and meta-analysis of published studies on endovascular repair of abdominal aortic aneurysm with the p-branch. Front Surg 2022;9:879682.
Radivoyevitch T, Weaver D, Hobbs B, et al. Do persons with chronic myeloid leukaemia have normal or near normal survival? Leukemia 2020;34:333-5.
Harisinghani MG. Pitfalls and mimics of lymph nodes on imaging. In: Harisinghani MG, ed. Atlas of lymph node anatomy. New York: Springer; 2013. pp 155-77.
Asif T, Mohiuddin A, Hasan B, Pauly RR. Importance of thorough physical examination: a lost art. Cureus 2017;9:e1212.

How to Cite

Natale, Francesco, Riccardo Molinari, Simona Covino, Roberta Alfieri, Mirella Limatola, Lorenzo De Luca, Enrica Pezzullo, Andrea Izzo, and Giovanni Cimmino. 2023. “A Pitfall in the Echographic Diagnosis of Abdominal Aortic Aneurysm: When Para-Aortic Lymph Nodes Are the Trick”. Monaldi Archives for Chest Disease 94 (1). https://doi.org/10.4081/monaldi.2023.2516.