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Page: Rupture
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The clinical manifestation of ruptured AAA can include low back, flank, abdominal or groin pain, but the bleeding usually leads to a hypovolemic shock with hypotension, tachycardia, cyanosis, and altered mental status. The mortality of AAA rupture is 75-90%, with 65% of patients dying before they arrive at hospital. The bleeding can be retroperitoneal or intraperitoneal, or the rupture can create an aortocaval or aortointestinal fistula.. Flank ecchymosis is a sign of retroperitoneal hemorrhage, and is also called the Grey-Turner sign. Ruptured AAA is a clinical diagnosis: the presence of the triad of abdominal pain, shock and pulsitile abdominal mass makes the diagnosis; no further investigations are required for diagnostic purposes, and imaging should be avoided unless specifically requested by a vascular surgeon.
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