Unruptured abdominal aortic aneurysm:
(1) usually asymptomatic
(2) may result in chronic, vague abdominal, back or flank pain
Complications of an unruptured aneurysm:
(1) ureterohydronephrosis
An aneurysm with impending rupture may present as severe lumbar pain.
Ruptured aneurysm may present with:
(1) sudden onset of pain in mid-abdomen or flank, with radiation into scrotum if male
(2) hypotension and shock
(3) pulsatile abdominal mass
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Point of Aortic Rupture
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Site of Hemorrhage
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Outcome
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anterolateral wall
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peritoneal cavity
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collapse and death
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posterolateral wall
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retroperitoneum
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biphasic rupture or chronic occlusion
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Biphasic rupture involves:
(1) a small tear with a small amount of bleeding
(2) a stable period of several hours
(3) occurrence of a larger tear with hypotension and shock
Infrequent complications of a ruptured aneurysm:
(1) aortoduodenal fistula
(2) aortocaval fistula
