False positive aortic dissection on abdominal ultrasound.

A 43-year-old man presented to the emergency department (ED) with epigastric pain radiating down the center of his abdomen. He denied significant use of alcohol or non-steroidal anti-inflammatory drugs. He had uncontrolled hypertension on hydrochlorothiazide and a blood pressure of 185/95 mmHg. A two-dimensional aortic ultrasound was done at the patient’s bedside and revealed a double lumen and an intimal flap on the longitudinal axis (Figure 1). The transverse view was limited due to body habitus and bowel gas.