Abdominal Radiology

, Volume 43, Issue 5, pp 1067–1083 | Cite as

Acute non-traumatic disease of the abdominal aorta

  • William Curtis
  • Motoyo Yano


Acute pathology in the abdominal aorta is associated with significant morbidity and mortality. The most feared complication of abdominal aortic disease is acute rupture in the setting of atherosclerotic abdominal aortic aneurysm. Although frank rupture often is easily diagnosed on CT, other findings such as a hyperattenuating crescent, discontinuous intimal calcium, and draping of the aorta are subtle signs of aneurysm instability. A true aneurysm should be distinguished from a rapidly growing, saccular pseudoaneurysm in the setting of infectious aortitis, as treatment strategy differs. Acute aortic syndrome involving the abdominal aorta, such as dissection and intramural hematoma, often is an extension of thoracic aortic disease, whereas penetrating atherosclerotic ulcers occasionally involve only the abdominal aorta. The goal of treating acute aortic pathology is to repair and prevent rupture, as well as restore and maintain perfusion of the lower extremities, kidneys, and mesentery. However, both open and endovascular repair of the abdominal aorta may become acutely complicated, resulting in compromise of these goals. Examples include aortoenteric fistula, endoleak, anastomotic pseudoaneurysm, graft infection, and thrombosis or kinking of a stent graft resulting in ischemia of the limbs and mesentery.


Aortic aneurysm Aortic injury Aortic rupture Aortic instability Non-traumatic aortic injury 


Compliance with ethical standards

Conflicts of interest

There are no potential conflicts of interest from either author. There were no human or animal participants in this work


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Authors and Affiliations

  1. 1.Mallinckrodt Institute of RadiologyWashington University School of MedicineSt. LouisUSA

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