Ruptured abdominal aortic aneurysm
The patient presented to the emergency department with central and lower abdominal pain which started 12 hours ago and was getting worse for the last three hours. The patient was found hypotensive (despite a history of hypertension) and anuric in the emergency department. Laboratory investigations showed acute renal failure.
Due to acute renal failure (with single left kidney), an urgent plain CT abdomen was performed after abdominal x-ray and renal ultrasound examination which showed ruptured abdominal aortic aneurysm, as described above. Due to hemodynamic instability, the patient was taken to the operating room immediately after the CT scan for open surgical repair. Contained ruptured infra-renal abdominal aortic aneurysm was found on surgery which was repaired. The patient recovered smoothly from surgery and was discharged in a stable condition after one week.
Interestingly, the patient had no previous history or imaging documentation of abdominal aortic aneurysm.