Clip 1: 6 cm AAA with thrombus in the periphery and hypoechoic lumen.
Clip 2: Free fluid at the caudal edge of the liver. Notice that if you stopped your evaluation at Morison’s Pouch, this would result in a false negative exam. An evaluation of the hepatorenal space must include the caudal edge of the liver as it has a higher sensitivity for free fluid than Morison’s Pouch.
A 60-something year old patient presents with flank pain radiating to the abdomen.
POCUS aorta shows a large AAA (Clip 1) with free fluid at the caudal tip of the liver (Clip 2).
Technique Pearls: Very helpful to first find your landmarks. The aorta lies just anterior to the vertebral body. If the depth on the ultrasound is too shallow (ie. showing only superficial structures), you may be looking at a vessel that is not the aorta.