Case Report: Ruptured Infrarenal Abdominal Aortic Aneurysm

A ruptured abdominal aortic aneurysm (AAA) is a life-threatening vascular emergency with high mortality rates. We report a case of a 79-year-old male with no reported past medical history but a significant lifelong smoking history who presented to the emergency department with generalized weakness, lower abdominal pain, hypotension, tachycardia, and a reported syncopal episode. Emergency medical services (EMS) found the patient at home during a welfare check, appearing pale and weak. Upon movement from his bed to a stretcher, he experienced a syncopal episode, became tachycardic, and was transiently hypoxic. Initial laboratory studies revealed a hemoglobin of 13 g/dL, hematocrit of 40.6%, and lactate of 7.3 mmol/L. Computed tomography angiography (CTA) of the abdomen and pelvis demonstrated a ruptured infrarenal AAA measuring 12.5 x 11.1 x 13.5 cm, with a large surrounding retroperitoneal hematoma and hemoperitoneum. This case highlights the importance of early recognition and emergent management of ruptured AAA, which requires prompt surgical intervention to improve survival outcomes.