European Journal of Cardiovascular Medicine

Abdominal aortic aneurysm (AAA) occurs mostly in the infrarenal component of the abdominal aorta (AA) when the diameter of the AA increases from 1.7cm in men and 1.5cm in women to a diameter greater than 3.0cm; this is clinically regarded as aneurysmal. This shows a male preponderance, with age greater than 65 years and common in individuals of European ancestry. This is a 70-year-old retired civil servant and known hypertensive that presented for a computed tomographic angiography (CTA) on account of a pulsatile mass in the mid abdomen. The CTA showed a contrast filled left laterally oriented saccular mass in the infrarenal aspect of the AA measuring about 108mm x 95mm in craniocaudal and mediolateral dimensions. This mass shows a left lateral projection; the nipple or crescent sign of imminent rupture, and a cleft like filling defect posterior and left laterally; thrombus fissuration sign of imminent rupture. A diagnosis of AAA with imminent rupture was made. The patient was placed on medical treatment among which is anticoagulant and antihypertensive therapy with preparation for surgical treatment but he opted for surgical treatment abroad. We report the radiologic findings of AAA with imminent rupture following CTA in an elderly male due to its peculiar presentation and rare nature.