{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T22:19:30Z","timestamp":1769465970638,"version":"3.49.0"},"reference-count":18,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,1,24]],"date-time":"2026-01-24T00:00:00Z","timestamp":1769212800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Acute aortic dissection is the most common and most severe manifestation of acute aortic syndrome. An isolated dissecting aneurysm of the abdominal aorta is defined as a dissecting aneurysm distal to the diaphragm and is an extremely rare disease. Detection of an intimal flap between two lumens using different imaging methods is a definitive diagnostic sign of aortic dissection. A number of studies have validated ultrasound, including point-of-care ultrasound, as the standard initial imaging modality for the diagnosis of aortic dissection. Case Presentation: We present a 39-year-old patient who was sent to our institution under the suspicion of renal colic. The clinical findings revealed pale discoloration of the skin with sweating and abdominal pain. An emergency ultrasound showed an abdominal aortic aneurysm with an intimal flap, as well as free perirenal fluid on the left side. Multislice computed tomography aortography was then performed and the findings indicated rupture of a dissecting aneurysm of the abdominal aorta with a large retroperitoneal hematoma. The patient was then sent to a tertiary institution where he underwent emergency surgery and successfully recovered. Conclusions: Isolated abdominal aortic dissection is a rare condition with often non-specific clinical presentation, making imaging crucial for diagnosis. Ultrasound plays an important role as an initial imaging modality, as the detection of direct or indirect signs of dissection enables timely referral for CT aortography, confirmation of the diagnosis, and initiation of appropriate treatment.<\/jats:p>","DOI":"10.3390\/reports9010035","type":"journal-article","created":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T11:14:07Z","timestamp":1769426047000},"page":"35","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Imaging-Based Diagnosis of a Ruptured Isolated Dissecting Abdominal Aortic Aneurysm: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0006-5128-9045","authenticated-orcid":false,"given":"Marija","family":"Varnicic Lojanica","sequence":"first","affiliation":[{"name":"U\u017eice General Hospital, 31000 Uzice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikola","family":"Milic","sequence":"additional","affiliation":[{"name":"U\u017eice General Hospital, 31000 Uzice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sretina","family":"Jovanovic","sequence":"additional","affiliation":[{"name":"U\u017eice General Hospital, 31000 Uzice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3144-0779","authenticated-orcid":false,"given":"Milica","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Clinic \u201cNarodni Front\u201d, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3269-3069","authenticated-orcid":false,"given":"Stefan","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Obstetrics and Gynecology Clinic \u201cNarodni Front\u201d, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,1,24]]},"reference":[{"key":"ref_1","first-page":"694","article-title":"Aortic dissection: A 250-year perspective","volume":"38","author":"Criado","year":"2011","journal-title":"Tex. Heart Inst. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1834","DOI":"10.1016\/0002-8703(91)90044-I","article-title":"Aortic dissection with the entrance tear in abdominal aorta","volume":"121","author":"Roberts","year":"1991","journal-title":"Am. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1016\/j.ejvs.2019.05.013","article-title":"Systematic review and meta-analysis of current literature on isolated abdominal aortic dissection","volume":"59","author":"Liu","year":"2020","journal-title":"Eur. J. Vasc. Endovasc. Surg."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"205","DOI":"10.1067\/mva.2002.125028","article-title":"Isolated dissection of the abdominal aorta: Clinical presentation and therapeutic options","volume":"36","author":"Farber","year":"2002","journal-title":"J. Vasc. Surg."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"299","DOI":"10.1016\/j.kjms.2011.11.010","article-title":"Acute aortic dissection: An update","volume":"28","author":"Chen","year":"2012","journal-title":"Kaohsiung J. Med. Sci."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1111\/acem.14839","article-title":"The sonographic protocol for the emergent evaluation of aortic dissections (SPEED protocol): A multicenter, prospective, observational study","volume":"31","author":"Gibbons","year":"2024","journal-title":"Acad. Emerg. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2046","DOI":"10.1016\/j.jvs.2019.04.467","article-title":"A systematic review and meta-analysis of isolated abdominal aortic dissection","volume":"70","author":"Wu","year":"2019","journal-title":"J. Vasc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1583\/08-2601.1","article-title":"Dissection of the abdominal aorta: Current evidence and implications for treatment strategies\u2014A review and meta-analysis of 92 patients","volume":"16","author":"Jonker","year":"2009","journal-title":"J. Endovasc. Ther."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1007\/s10016-003-0100-4","article-title":"Spontaneous infrarenal abdominal aortic dissection presenting as claudication: Case report and review of the literature","volume":"18","author":"Farber","year":"2004","journal-title":"Ann. Vasc. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1378\/chest.78.6.805","article-title":"Atherosclerosis and aneurysm of aorta in relation to smoking habits and age","volume":"78","author":"Auerbach","year":"1980","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"113","DOI":"10.1007\/s11886-021-01541-z","article-title":"Computed tomography imaging of aortic dissections with endovascular treatment considerations","volume":"23","author":"Vargo","year":"2021","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Shaiea, S., He, X., Mansai, H., Aldali, F., Hashem, A., Heng, Y., and Zeng, H. (2025). Clinical Characteristics and Prognosis in Spontaneous Isolated Abdominal Aortic Dissection Based on the Dissection Length. J. Clin. Med., 14.","DOI":"10.3390\/jcm14165849"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1136\/heartjnl-2019-314897","article-title":"Imaging for acute aortic syndromes","volume":"106","author":"Carroll","year":"2020","journal-title":"Heart"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"902","DOI":"10.1016\/j.jcmg.2018.03.009","article-title":"Multimodality imaging of thoracic aortic diseases in adults","volume":"11","author":"Bhave","year":"2018","journal-title":"JACC Cardiovasc. Imaging"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"962","DOI":"10.1016\/j.crad.2013.04.007","article-title":"Common and uncommon CT findings in rupture and impending rupture of abdominal aortic aneurysms","volume":"68","author":"Ahmed","year":"2013","journal-title":"Clin. Radiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e01745","DOI":"10.1213\/XAA.0000000000001745","article-title":"Diagnostic ultrasound: On-site diagnosis of type B aortic dissection during cataract surgery","volume":"18","author":"Fujita","year":"2024","journal-title":"A A Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/s12245-023-00579-w","article-title":"Ruptured Abdominal Aortic Aneurysm Discovered by Pocket-Sized Ultrasound in a Low-Resource Setting: A Case Report","volume":"17","author":"Alasasfeh","year":"2024","journal-title":"Int. J. Emerg. Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1002\/jcu.23850","article-title":"Enhancing Clinical Outcomes: Point-of-Care Ultrasound in the Precision Diagnosis and Management of Abdominal Aortic Aneurysms in Emergency Medicine: A Systematic Review and Meta-Analysis","volume":"53","author":"Shaban","year":"2025","journal-title":"J. Clin. Ultrasound"}],"container-title":["Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/35\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T11:51:39Z","timestamp":1769428299000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2571-841X\/9\/1\/35"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,24]]},"references-count":18,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,3]]}},"alternative-id":["reports9010035"],"URL":"https:\/\/doi.org\/10.3390\/reports9010035","relation":{},"ISSN":["2571-841X"],"issn-type":[{"value":"2571-841X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,24]]}}}