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Ruptured abdominal aortic aneurysm - contained

Case contributed by Sajoscha A. Sorrentino
Diagnosis certain

Presentation

Severe back pain.

Patient Data

Age: 60 years
Gender: Male

Patient was referred for CT scan to exclude aortic dissection. Little did the patient know, a contained rupture of a previously unknown abdominal aortic aneurysm was diagnosed. Surgery was performed and the patient walked home two weeks later.

Case Discussion

Ruptured aneurysms present with severe abdominal or back pain and hypotension/shock. The mortality rate from a ruptured AAA is high: 59 to 83% of patients die before they make it to hospital or undergo surgery. The operative mortality rate for those who make it to surgery is approximately 40%.

CT angiography

  • is the gold standard but a high radiation dose

  • excellent for pre-operative planning as it accurately delineates the size and shape of the AAA and its relationship to branch arteries and aortic bifurcation

  • superior to ultrasound in detecting and sizing common iliac artery aneurysms

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