Ruptured Abdominal Aortic Aneurysm

Debra A. Gervais, M.D., and Gary J. Whitman, M.D.

N Engl J Med 1996; 334:27January 4, 1996

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Figure 1 An 85-year-old man was brought to the emergency room after two hours of excruciating abdominal pain, nausea, and vomiting. He was hypotensive on admission. Physical examination revealed a pulsatile midabdominal mass. Emergency computed tomography revealed a ruptured abdominal aortic aneurysm (straight arrows). Surgical findings confirmed that the aneurysm had ruptured, with hemorrhage (curved arrows) into the right anterior pararenal space. Cardiac arrest occurred intraoperatively. The patient was resuscitated and taken to the surgical intensive care unit. On arrival, he had a second cardiac arrest and died despite vigorous resuscitative efforts.

Kim Eagle, M.D.

Debra A. Gervais, M.D.
Gary J. Whitman, M.D.
Massachusetts General Hospital, Boston, MA 02114

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