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The primary indication for emergent ultrasonography of the aorta is to identify an abdominal aortic aneurysm (AAA). AAAs develop slowly and may be asymptomatic or present with life threatening rupture. AAA rupture accounts for more than 10,000 deaths per year in the United States. When ruptured or leaking AAA is suspected, ultrasound has many appealing qualities. Particularly for the hemodynamically unstable patient, bedside ultrasonography offers a prompt, accurate diagnosis. Although ultrasound is an excellent modality for identifying AAA, it is not effective in identifying whether rupture or leaking has occurred. The decision that an AAA is ruptured is typically based on ultrasound findings of the presence of an aneurysm as well the patient's clinical presentation. The presence of an obese body habitus or bowel gas may lead to poor quality ultrasound imaging and make accurate assessment of AAA difficult.
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