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DESCRIPTION
CT images of a 86-year-old man who presented with a 24-hour history of right loin pain. Abdominal x rays revealed bilateral staghorn calculi and urine analysis suggested urinary tract infection. A CT scan of his abdomen, done under the renal protocol to visualise the urinary tract better, revealed the unexpected presence of a contained rupture of an abdominal aortic aneurysm.
LEARNING POINTS
Older patients often present with atypical signs and symptoms and concurrent pathologies.2
A common pitfall is to discontinue further investigations on obtaining initial investigative evidence in support of a provisional diagnosis.
Where available, cross-sectional imaging by CT is a high value, high yield, examination enabling the consideration of a broader range of pathologies.
We recommend a low threshold for CT scanning in elderly patients with confusing abdominal symptoms. An ultrasound scan would be an alternative to exclude major pathologies.
Footnotes
Competing interests: none.
Patient consent: Patient/guardian consent was obtained for publication.