Clinical Practice and Cases in Emergency Medicine

Case Presentation: A 78-year-old woman who presented to the emergency department with abdominal pain was found to have a tender, pulsatile abdominal mass on examination. Point-of-care ultrasound demonstrated an abdominal aortic aneurysm with findings concerning for active rupture. Emergent computed tomography angiography confirmed rupture with a large retroperitoneal hematoma. 

Discussion: Ruptured abdominal aortic aneurysm is a catastrophic diagnosis associated with high mortality, particularly when recognition is delayed. Point-of-care ultrasound is well established for identifying aneurysmal dilation; however, direct visualization of active rupture is rarely described.