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Ruptured abdominal aortic aneurysm — ACEM Fellowship MCQ

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EasyGI/Abdominal emergenciesRuptured abdominal aortic aneurysmACEM Fellowship

A 74-year-old man presents to a regional ED, triage category 1, with sudden abdominal and back pain. BP 78/42, HR 126. He is pale with a tender pulsatile abdominal mass. Bedside ultrasound shows a 7.2 cm aorta and free intraperitoneal fluid. What is the most likely diagnosis?

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Correct answer: B — Ruptured abdominal aortic aneurysm

Hypotension, back or abdominal pain and a pulsatile mass with enlarged aorta on bedside ultrasound indicate ruptured AAA.

Reference: ACEM abdominal emergency curriculum; vascular emergency guidance