PMC4278087_01
Dr. Kumaresh Athiyappan
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Color Doppler showed swirling blood flow within it [Figure 1].
65-year-old woman with pain in the abdomen diagnosed due to arc of Riolan aneurysm. Ultrasound of the abdomen with color Doppler shows a large saccular aneurysm (arrowhead) within the abdomen in the left lumbar region. Color Doppler shows swirling blood flow within it. No thrombus was seen.
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Following USG, the patient underwent a computed tomography (CT) angiography which showed severe diffuse atherosclerotic calcification of the abdominal aorta with occlusion of the ostia of celiac trunk [Figure 2a] and (~50% diameter reduction) stenosis of SMA origin [Figure 2b].
65-year-old woman with pain in the abdomen diagnosed with arc of Riolan aneurysm. (a) CT scan - sagittal maximum intensity projection (MIP) in arterial phase shows occlusion of the celiac origin (asterix) with diffuse atherosclerotic calcifications in the abdominal aorta. (b) CT scan - axial section in the arterial phase at the level of SMA origin shows a calcific plaque at the origin causing ~50% diameter stenosis (left arrow). Also seen is the arc of Riolan aneurysm (arrowhead).
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Incidentally, the arc showed a large saccular aneurysm (~30 x 30 mm) in its mid portion [Figures 3a, b and 4]. Another saccular aneurysm (~15 x 5 mm) was seen involving the distal gastroduodenal artery [Figure 3a and b].
65-year-old woman with pain in the abdomen diagnosed with arc of Riolan aneurysm. a) CT scan - coronal maximum intensity projection (MIP) in the arterial phase of abdomen shows the arc of Riolan with aneurysm (arrowhead) and gastroduodenal artery aneurysm (down arrow). b) CT scan volume-rendered imaging in arterial phase shows the arc of Riolan with aneurysm (arrowhead) and gastroduodenal artery aneurysm (down arrow).
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Incidentally, the arc showed a large saccular aneurysm (~30 x 30 mm) in its mid portion [Figures 3a, b and 4].