COTW: Just a little bit of an aortic dissection

Our ultrasound case of the week is a 56y/o male who presented to the ED for a second time with abdominal pain. It was sharp but mild, located in the lower midline. He looked great and work-up was initially negative. However, a quick bedside ultrasound of the aorta showed the below clip.

Distal aorta in long-axis.

Distal aorta in long-axis.

Its not obvious, but there seemed to be an irregularity in the lumen. This prompted a CTA showing a small dissection.

Aortic dissection is apparent as there are 2 separate enhancing lumens of the aorta.

Aortic dissection is apparent as there are 2 separate enhancing lumens of the aorta.

This patient was admitted, medically managed, and discharged 2 days later.

This is a great example of how a bedside ultrasound cinched a potentially serious diagnosis when all else seemed normal.