could an ultrasound miss detecting abdominal aortic aneurysm?

answered:

Dx of AAA

Aortic_aneurysm
Ultrasound is one of the typical studies used to diagnose AAA. It is optimal to let the tech doing the study know if you are trying to look specifically for an aneurysm. The bigger the aneurysm, the more likely it is to be picked up. In other words a very small one would have a higher likelihood to be missed.
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Abdomen Abdominal aortic aneurysm Aneurysm Aorta Aortic aneurysm Sonogram

Yes

Aortic_aneurysm
If the patient is large and/ or has a lot of gas in the bowel then the aorta might not be well seen. Such an exam would be described as sub-optimal and could not rule out an aneurysm. If the aorta was well seen from above the celiac artery to the aortic bifurcation then no significant aortic aneurysm should be missed.
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Abdomen Abdominal aortic aneurysm Aneurysm Aorta Aortic aneurysm Artery Bowel Celiac disease Flatulence Gas