A Life-Threatening Cause of Abdominal Pain

Case Outcome:

Following review of the abdominal x-ray, an urgent CT aortogram was undertaken which showed an abdominal aortic aneurysm (AAA) measuring 13 cm in width and 18.9 cm in length (Figure 2 and 3). Furthermore there was some stranding of tissue around the margins of the aorta superiorly consistent with an early leak of the aneurysm. Surgical repair of the giant AAA was carried out; however two days after operation the patient deteriorated suddenly and despite all attempts at resuscitation, he passed away.

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.