A 67-year-old man, chronic smoker, presented to the ER with sudden, intense and persistent abdominal and back pain along with altered mental status. O/E: – Hypotension Tachycardia Cyanosis. On abdominal examination, a tender, pulsatile and an expansile mass was noted in the umbilical and the epigastric region. Patient was immediately taken up for surgery but the patient did not survive. On checking the old repos of the patient, some abnormal mass was noted in the abdomen. A CECT film was also found. In asymptomatic cases, what is the indication of surgery?
Correct Answer: 5.5 cm
Description: This is a case of abdominal aoic aneurysm rupture into the intraperitoneal cavity leading to frank shock. Image 1 shows abdominal aoic aneurysm. Image 2 shows hyperdense crescent sign which is a sign of impending aoic rupture Abdominal Aoic Aneurysm Males > females Incidence increases with age Cigarette smoking is a potent modifiable risk factor. M/C below the level of renal aeries 90% associated with atherosclerosis Normally asymptomatic Causes acute pain and hypotension on rupture For asymptomatic aneurysms, abdominal aoic aneurysm repair is indicated if the diameter is >=5.5 cm.
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