Ruptured abdominal aortic aneurysm

Case contributed by RMH Core Conditions

Presentation

Severe lumbar back pain and right hip pain.

Patient Data

Age: 92
Gender: Female

Abdominal aortic aneurysm detected measuring 4.7cm x 4.9cm in maximal dimension at the L2 vertebral body extends from below the level of renal artery origins to above the aortic bifurcation.. Large right sided retroperitoneal haematoma appears to arise from this segment of the abdominal aorta. This haematoma measures 10cm (AP) x 8.4cm (trans) x 12.6cm (SI) and displaces the right kidney laterally. There is a small/moderate amount of free intraperitoneal fluid within the pelvis.

Conclusion

Ruptured abdominal aortic aneurysm, with a large retroperitoneal haematoma. The treating team has been informed of the findings

Case Discussion

Key learning points:

  • 80% rupture into the retroperitoneum and 20% rupture into the peritoneal cavity as well as into the retroperitoneum
  • the classical clinical triad (hypotension, pain and pulsatile mass) is only present in 25-50% of patients with a ruptured AAA
  • there are many indicators of increased AAA rupture risk including size >7cm; increasing size >1cm per year; discontinuity of calcification and hyperattenuating crescent sign
  • very high mortality of >90%
PlayAdd to Share

Case information

rID: 31145
Case created: 21st Sep 2014
Last edited: 10th Sep 2015
System: Vascular
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.