Case Report: A 76 year old man presented to the emergency department with gradual onset abdominal pain over a period of 24 hours and generalised lethargy. The abdominal pain was central with no radiation and was described as an ache by the patient. There was no history of vomiting. He had a 45 pack-year history of smoking. He was noted to have a blood pressure of 150/60 mmHg, pulse of 130 beats per minute, temperature of 36.5oC and saturations of 95% on room air. [download-attachments container="div" style="list" display_icon="1" display_count="1" display__size="0"]