In this image, you see the aorta is enlarged. The aorta is identified as a pulsatile vascular structure just anterior to the spinal vertebrae and their associated artifactual spine shadow. The normal aorta is less than 3cm in diameter, including the walls. This patient had a known AAA that had previously been repaired, and came to the ED with painless, copious, red blood per rectum.  No free fluid was visible in the peritoneum. The patient had a stat CT scan of his abdomen that confirmed an aorta-enteric fistula with hemorrhage.

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