Abdominal aortic aneurysm rupture is a complication of abdominal aortic aneurysm and is a surgical emergency. The diagnostic suggestion is based on retroperitoneal hemorrhage adjacent to the aneurysm extending to perirenal, pararenal spaces, or the psoas muscles.

On contrast CT, the active contrast extension to the periaortic hematoma is suggestive especially if it passes through the aneurysmal wall and mural thrombus. Aneurysm larger than 7 cm is at high risk of rupture. In this case, it measured 10 x 11 cm.

Treatment of an acute rupture should be prompt and can be with endovascular aneurysm repair (EVAR) or open surgery. The mortality rate is very high, >90%.