Case presentation A 68-year-old man presents to the emergency department with a 1-hour history of pain in the left side of his abdomen. The pain suddenly started when he was getting up from a chair. Then, it became constant and radiated through his back. His past medical history includes hypertension and stable angina. He lives with his wife and usually is independent. Examination The patient is pale, sweaty, and clammy.
His pulse is 100/min, and his blood pressure is 90/50 mmHg. Heart sounds are normal, and the chest is clear. Examination of the abdomen reveals a sizeable tender mass in the epigastrium. The mass is both pulsatile and expansile. The peripheral pulses are present and equal on both sides, and there is no neurological deficit. Investigations Hemoglobin: 3 g/dL (11.5–16.0 g/dL) Mean cell volume: 86 fL (76–96 fL) White cell count: 5 × 10 9 /L (4.0–11.0 × 10 9 /L) Platelets:…
