Casual detection of an abdominal aortic aneurysm thanks to a trainee-made ultrasound with two subsequent “domino” diagnoses: case report and insights on the role of ultrasound courses

Early detection of abdominal aortic aneurysm (AAA) is crucial as untreated lesions can be life-threatening. We describe the case of a fortuitous ultrasound (US) detection of AAA by a trainee which allowed two subsequent “domino” diagnoses. A 69 y.o. male underwent US to evaluate prostate and bladder. He was a heavy smoker affected by hypertension and dyslipidemia. An endocrinology resident and ultrasound trainee started the exam accidentally from the epigastrium and found a fusiform aneurysmal lesion. Subsequent computed tomography (CT) scan confirmed the diagnosis of AAA and incidentally revealed a colon adenocarcinoma and a diffuse non-Hodgkin lymphoma. This case report underlines the importance of extending the abdominal US examination to the aorta in patients over 60 years of age (especially in those people with multiple risk factors for AAA) and emphasizes the critical role of organizing hands-on-patient US courses with a multidisciplinary approach to optimize the training of future sonographers.