Crescent sign in abdominal aortic aneurysm

Description

A 70-year-old man referred to emergency department with acute onset of severe flank pain. In initial examinations, the patient was pale, with pulse rate of 120/min and blood pressure of 95/65. In abdominal palpation a pulsatile mass was detectable. Urgent resuscitation was done.

The patient had been known to have hypertension and abdominal aortic aneurysm (AAA) since 7 years ago. Abdominal CT scan without and with contrast injection (figures 1 and 2) showed a large fusiform abdominal aorta with crescentic focus of hyperdensity (black arrow) within the mural thrombus (white arrow), known as high-attenuating crescent sign. Retroperitoneal haematoma was also observed anterior to psoas muscles bilaterally (asterisks). Endovascular repair was chosen as an emergent surgical procedure. The patient was discharged on postoperative day 7, and recovery was uneventful.

Figure 1

Non-contrast enhanced abdominal CT scan shows an abdominal aorta aneurysm with mural thrombosis...

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