History A 68-year-old man presents to the emergency department with a 1-h history of pain in the left side of his abdomen. The pain started suddenly while he was getting up from a chair. It became constant and radiated through to his back. His past medical history includes hypertension and stable angina. He lives with his wife and is normally independent. Examination The patient is pale, sweaty and clammy. His pulse is 100/min and the blood pressure is 90/50 mmHg. Heart sounds are normal and the chest is clear.
Examination of the abdomen reveals a large tender mass in the epigastrium. The mass is both pulsatile and expansile. The peripheral pulses are present and equal on both sides. There is no neurological deficit. What is the most likely diagnosis? *This image case is from Docplexus Editorial Team for educative purpose only. Source: 100 cases in surgery
