Print Email
 

Clinical Images

Back Pain and an Abnormal Abdominal X-Ray

Babak Abai, MD
Drew L. Kotler, BA 
Michael J. Pucci, MD
Adam C. Winters, BS

September 26, 2014

A 68-year-old male with hypertension and a prior appendectomy presented to our institution with a two-week history of sharp, intermittent back and abdominal pain. The pain responded minimally to non-steroidal anti-inflammatory drugs. The patient denied change in bowel habits or a recent history of trauma. The patient was a former smoker with a 20 pack-year smoking history. A focused physical exam revealed clear lungs, a normal heart exam and a soft, non-tender, non-distended abdomen. Routine laboratory work was within normal limits. An abdominal x-ray was obtained (Figure 1). A subsequent CT angiogram confirmed the diagnosis of abdominal aortic aneurysm (AAA) with a diameter of 4.9 cm (Figure 2).

Abdominal_Image2_Kotler.jpg
(Figure 1)

Abdominal_Image1_Kotler.jpg
(Figure 2)


 


Click here to view answer

Author bios:

Drew Kotler and Adam Winters are both 4th year Medical Students at Sidney Kimmel Medical College at Thomas Jefferson University.  Both are entering residencies in Internal Medicine.

Dr. Babak Abai is an Assistant Professor of Surgery specializing in Vascular Surgery at Thomas Jefferson University.

Dr. Michael Pucci is an Assistant Professor of Surgery specializing in Minimally Invasive Surgery at Thomas Jefferson University.


REFERENCES

1.Palazzuoli A, Gallotta M,  Guerrieri G, et al. Prevalence of risk factors, coronary and systemic atherosclerosis in abdominal aortic aneurysm: comparison with high cardiovascular risk population. Vasc Health Risk Manag. 2008;4(4): 877

2. Brewster DC, Cronenwett, JL, Hallett J, et al. "Guidelines for the treatment of abdominal aortic aneurysms: report of a subcommittee of the Joint Council of the American Association for Vascular Surgery and Society for Vascular Surgery." J Vasc Surg  2003;37(5): 1106-1117

3. A Dunne, Jonathan, et al. "Statins: the holy grail of Abdominal Aortic Aneurysm (AAA) growth attenuation? A systematic review of the literature." Current vascular pharmacology 12.1 (2014): 168-172.

FIGURE LEGENDS
Figure 1. Abdominal x-ray demonstrating an abdominal mass with calcified rim. 
Figure 2. Coronal computed tomography scan demonstrating an infrarenal abdominal aortic aneurysm. 

 


 

Submit content to JGIM

JGIM encourages submission of articles aimed at improving patient care, education, and research in primary care and general internal medicine in all settings. Submissions must be original and not currently under consideration for publication in another peer- reviewed medium (paper or electronic).

Learn How to Submit Here

 

FEATURED ARTICLE

 

Darlyn Victor, MD, Paul Moots, MD and Jacqueline Fischer, MD

October 13, 2016

A 39-year-old African-A....

Read Article
 

Most Viewed Articles

73 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
25 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF
31 Views

The Role of Community-Based Participatory Research to Inform Local Health Policy: A Case Study.

O’Brien, Matthew J.; Whitaker, Robert C.

Read Article| Download PDF

Most Recent Web Only Content

January

17

On the Penetrating Capacity of Ultrasound

Sarah Bugg

Read Article

December

20

Painful Eruption in a Mountain Biker

Jasna Ikanovic, MD and Animita Saha, MD

Read Article

November

19

Adverse Events In US Hospitals:1 in 3 Admissions Has At Least One Adverse Event

SGIM Evidence-Based Medicine Task Force

Read Article

August

25

Diagnostic Schema

Denise M. Connor, Rabih Geha, Mark Henderson, Jeff Kohlwes

Read Article