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Images in cardiovascular medicine: Giant abdominal aortic aneurysm.

An 88-year-old man with a history of smoking, hypertension, and hyperlipidemia was admitted for assessment of a painless abdominal mass. Five years earlier, he had noticed a painless, slowly enlarging abdominal mass; since he was otherwise asymptomatic, he did not seek medical attention. Physical examination revealed a pulsatile, well-defined, nontender abdominal mass (Movie I in the online-only Data Supplement), and a mild bruit was heard on auscultation. Peripheral pulses were palpable in both lower limbs. Ultrasonography of the abdomen showed a giant aortic aneurysm with a large mural thrombus (Figure 1A) and the central sector detected turbulent color flow with duplex image (Movie II in the online-only Data Supplement). Abdominal computed tomography (CT) with intravenous administration of contrast material revealed a …