INFRARENAL AORTIC ANEURYSM: AN INCIDENTAL RADIOLOGICAL FINDING

A 71-year-old man presented to the Emergency Department (ED) with worsening colicky left-sided flank pain radiating to his groin for 2 days. The patient had a 1-year history of intermittent left-sided pain, similar in nature but of reduced severity. There was no other significant past medical history. On arrival in the ED the patient was hemodynamically stable, with a pulse rate of 92 beats/min and a right arm blood pressure of 134/87 mm Hg. His physical examination revealed a tender left loin with guarding. The abdomen was otherwise soft with no palpable masses, no renal bruits, and normal bowel sounds. Femoral pulses were present bilaterally and of equal character. He had warm, pink-colored extremities with no evidence of hypoperfusion. Urine dipstick testing showed microscopic hematuria and proteinuria. Plain abdominal radiographic images were obtained and did not reveal any abnormal findings. According to his clinical features and initial investigation findings, an intravenous urogram (IVU) was performed to exclude ureteric calculi. The IVU was reported as having no renal tract calcifications with normal, unobstructed pelvicalyceal systems. A larger distance between the lumbar vertebrae and the left ureter in comparison to the right sidewas identified (Figure 1). This unusual radiological finding alerted the clinicians and radiologists to a possible alternative diagnosis. Abdominal computed