Acute left renal cyst hemorrhage / rupture on the background of autosomal dominant polycystic kidney disease (ADPKD).

Cyst rupture is a known complication of ADPKD. This case illustrates an additional history of the often more catastrophic vascular complications associated with ADPKD such as aneurysm formation (e.g. abdominal aorta and celiac axis in this case).

The patient had previously had an abdominal aortic aneurysm, which had ruptured and underwent open repair. The prior open surgery had lead to multiple adhesional small bowel obstructions. Therefore, imaging was very useful in this 'undifferentiated abdominal pain' presentation.