GI Radiology

20 year old male undergoes routine abdominal sonography. An interesting finding is present in the transverse images through upper abdomen. What is the most plausible explanation for this salient finding?

Diagnosis

Sometimes lower dorsal aorta appears duplicated, this is due to refraction of ultrasound waves by rectus abdominis muscle off midline. Even on color Doppler evaluation two lumens are seen. Coeliac axis may also appear duplicated (as in this case).
True duplication of aorta is extremely rare. A short segment duplication of aortic lumen termed as fenestration is also extremely rare. Confusion can be solved by angling the probe and seeing the midline structures from a paramedian window. Inexperience and unaware of this not so common artifact can lead to a false diagnosis of aortic duplication.

References:
1.Images in Nephrology, Ultrasonographic fata morgagna Nephrol Dial Transplant (2003) 18: 845-846

2. Aortic duplication artefact in a 14-year-old girl   Pediatric Radiology  Volume 34, Number 6 / June, 2004