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

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