Ruptured abdominal aortic aneurysm
Abdominal pain then collapse
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A large infra-renal abdominal aortic aneurysm is seen with interruption of the mural calcification at its anterior aspect. The lumen of the aneurysm is seen partially thrombosed with areas of contrast trickling through the thrombus and the posterior wall of the aneurysm showing active extravasation of the contrast.
This is associated with a large retroperitoneal hematoma collection extending to the left para- and peri-nephric spaces.
Note that the IVC is seen slit-like and the adrenals are hyper-enhancing.
Ruptured abdominal aortic aneurysm is one of the devastating emergency cases where the saying "time is life" comes to a reality situation and should be learned to every junior radiologist.
In this case, there is active bleeding from the ruptured abdominal aortic aneurysm with the signs of blood loss and shock radiologically appreciable.
In such a case, direct contact with the emergency and vascular staff is a must.