A man with abdominal pain who collapsed

A 79-year-old man with no remarkable medical history complained of sudden-onset severe abdominal pain while he was on a phone call with his friend and lost contact. When emergency medical personnel arrived, they found him at home lying on the floor gasping for air without a palpable pulsation. Cardiopulmonary resuscitation was initiated immediately. Upon arrival at the emergency department, his initial heart rhythm was evaluated; pulseless electrical activity was noted. An ultrasound performed during resuscitation to identify possible reversible causes revealed a huge shrunken cyst in the upper abdomen surrounded by many free fluids (Figure 1, Video SE1). Ruptured AAA is one of the most lethal aortic emergencies.1 A previous study reported an overall mortality rate of >80% for out-of-hospital rupture cases.2 Ruptured AAA should always be considered in patients in shock or even in those progressing to cardiac arrest with complaints of severe abdominal or back pain. Ultrasound is the first-choice procedure to rapidly identify AAA and facilitate early decision making.3, 4 In our case, considering the disease's high mortality rate and the patient's advanced age, his son agreed to terminate all resuscitation efforts. Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.