Misleading presentation of ruptured abdominal aortic aneurysm and the role of point-of-care ultrasound for diagnosis

Abstract

If not recognized and treated early enough, the rupture of abdominal aortic aneurysm (rAAA) embodies a devastating medi-cal emergency. It is associated with high morbidity and mortality which can reach up to 100 % in untreated individuals. Pa-tients are usually hypotensive, shocked, complain of pain in the abdomen or back, and can have a palpable pulsatile abdomi-nal mass. rAAA can be misdiagnosed due to patient’s comorbidities, site of rupture, or unusual presentations. Unusual clini-cal presentations include transient lower limb paralysis, right hypochondrial pain, groin pain, testicular pain, iliofemoral ve-nous thrombosis, and others. When rup-tured abdominal aneurysm is suspected an emergency ultrasound should be per-formed. In this article we are going to pre-sent a patient with unusual presentation of ruptured abdominal aneurysm and the importance of point-of-care ultrasound in similar cases.