Introduction and Importance: Abdominal aortic aneurysm (AAA) is a potentially fatal condition characterized by full-thickness dilation of the abdominal aorta, most commonly in the infrarenal segment. While rupture usually occurs spontaneously, trauma can act as a precipitating factor in predisposed individuals. Early recognition and timely surgical intervention are vital to survival. Case Presentation: A 70-year-old hypertensive male with a 45-pack-year smoking history presented in shock with acute abdominal pain following a low-impact fall. Examination revealed a pulsatile abdominal mass. CT showed a 5.5 × 3.5 cm infrarenal fusiform aneurysm with focal outpouching and mural thrombus suggestive of contained rupture. The patient underwent emergency open repair using an inverted Y-shaped PTFE graft. Intraoperatively, a retroperitoneal rupture with organized intraluminal clot and about 300 ml of blood-stained fluid was noted. Recovery and 6-month follow-up were uneventful. Clinical Discussion: This case illustrates that even minor blunt trauma can precipitate rupture in a vulnerable aneurysm. The intraluminal thrombus can act as a transient mechanical tamponade, temporarily sealing the rupture site and delaying fatal hemorrhage. This contained rupture provides a narrow but critical window for diagnosis and intervention. CT angiography plays a pivotal role in confirming aneurysm morphology, detecting retroperitoneal hematoma, and guiding operative planning. Recognition of this phenomenon is vital for timely surgical decision-making. Conclusion: Low-impact trauma can trigger a contained rupture of AAA. The life-saving tamponade effect of intraluminal clot highlights the importance of rapid diagnosis and prompt surgical management in improving outcomes.
Paudel et al. (Fri,) studied this question.