4.5

4.5 aaa aneurysm will i need surgery, I am seeing a vascular surgeon first time?

INDICATION: AAA ON US AND CT QUESTIONS GROWTH MOST RECENTLY 4.5CM SUMMER 2025 CT STONE
STUDY ? MAX DIAM AP OR TRANSVERSE ? EVAR TX OPTION ? ANEURYSM ELSEWHERE ? COMPARE TO PREVIOUC CT
2025 SUMMER

COMPARISON: Previous abdomen pelvis CT from July 23 2025

FINDINGS:

Evaluation of the solid organs and vasculature is limited by the absence of contrast

Thorax

Thyroid gland is normal. No significant axillary mediastinal or hilar lymph node. 7 mm pericardial
effusion, with physiologic limits. No pleural effusion.

There is a subtle infiltrate in the lower aspect of the right upper lobe, nonspecific. No suspicious
lung nodule.

The endobronchial tree is patent.
The thoracic wall is normal.
No significant aneurysmal dilation of the thoracic aorta.

Abdomen pelvis

5 mm calcification in the hepatic dome, no suspicious hepatic lesion. No intrahepatic or extrahepatic
bilateral dilatation. The gallbladder is normal.

The spleen is normal. The adrenal glands are normal.

21 mm right parapelvic cyst. The left kidney is within normal limits.

Fatty infiltration of the pancreas. No suspicious pancreatic mass. 8 mm peripancreatic lymph node
unchanged from previous 42 mm x 45 mm x 73 mm abdominal aorta aneurysm. The neck of the aneurysm
starts approximately 75 mm from the renal arteries. There is an aneurysmal dilation of the right
common iliac measuring up to 27 mm. The abdominal aneurysm and iliac aneurysm are unchanged when
compared to previous exam. The left iliac artery measures 18 mm. The femoral arteries are of good
caliber with no significant atherosclerotic changes.

Mild-to-moderate sigmoid colon diverticulosis with no evidence of diverticulitis. The small bowel is
normal. The appendix is normal.

Small bilateral ureterocele. 25 mm x 13 mm bladder diverticuli in the anterior part of the bladder.

No free fluid. The prostate is normal in size.

No significant abdominal lymph nodes.

Bones

L2 fracture with intervertebral height loss estimated at 80%. There is mild retropulsion of the
vertebral body in the central canal causing a mild to central canal stenosis with an AP diameter of 9
mm. This fracture is unchanged when compared to previous exam. Multilevel mild degenerative changes.
No suspicious bone lesion.

IMPRESSION:

Unchanged abdominal aorta aneurysm as described above.
Interventional radiology consultation to be considered for definitive opinion on EVAR possibility.

Unchanged right iliac aneurysm.
Nonspecific changes in the right upper lobe most likely inflammatory or post infectious. Follow-up
study in 3-6 month is suggested.