Ruptured aortic abdominal aneurysm

Case contributed by Dr Ian Bickle

Presentation

Upper abdominal pain, nausea. On exam, pulsatile mass in the upper abdomen. Drop in hemoglobin on serial gases. Renal impairment.

Patient Data

Age: 85 years
Gender: Female

Paramidline curvilinear calcification in keeping with an aortic aneurysm.

9.4 cm juxta/infrarenal aortic aneurysm extending to the aortic bifurcation.

Bilateral retroperitoneal hemorrhage, more on the right.

Atrophic right kidney.

Simple liver cysts.

Case Discussion

This is nearly as big an aneurysm as one will observe.

The non-contrast appearance is that of a retroperitoneal hemorrhage from a ruptured aneurysm.

Don't mess with contrast and the delay that will ensue. The answer to dictate management is on this scan. Time is of the essence in achieving a successful positive team outcome for the patient.

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