Abstract
A 66-year-old man underwent enhanced computed tomography (CT) and magnetic resonance imaging (MRI) for investigation of hypertension. These imaging studies revealed a 50-mm diameter abdominal aortic aneurysm (AAA) associated with retroperitoneal hematoma. No leg edema or deep vein thrombosis were present. At operation, two rupture sites were demonstrated; one on the right lateral wall of the abdominal aorta below the right renal artery near the inferior vena cava, and other on the posterior wall of the left common iliac artery. The latter exhibited a punched-out defect. Faint ulceration was visible on the aneurysm surface and this appeared to be involved in the onset of rupture. However it was the possibility of pseudoaneurysm due to the penetrating atherosclerotic ulcer was difficult to rule out.
