A patient with an abdominal aortic aneurysm may or may not present with symptoms depending on whether it has ruptured or if there are complications.


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

Point of Aortic Rupture

Site of Hemorrhage


anterolateral wall

peritoneal cavity

collapse and death

posterolateral wall


biphasic rupture or chronic occlusion


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


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