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Ruptured abdominal aortic aneurysm — RCPSC EM MCQ

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HardGI/Abdominal emergenciesRuptured abdominal aortic aneurysmRCPSC EM

A 76-year-old man has abrupt abdominal and back pain with syncope. He is pale, blood pressure 82/46 mmHg, heart rate 124/min, and bedside ultrasound shows a 7.2 cm abdominal aortic aneurysm with free intraperitoneal fluid. What is the most appropriate next step?

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Correct answer: D — Permissive resuscitation and immediate vascular surgery activation

A ruptured abdominal aortic aneurysm with shock requires immediate vascular surgery and balanced resuscitation, avoiding delays for non-essential imaging in an unstable patient.

Reference: Canadian vascular surgery and emergency medicine practice