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Case Reports
. 2025 Oct 28;17(10):e95582.
doi: 10.7759/cureus.95582. eCollection 2025 Oct.

Ruptured Abdominal Aortic Aneurysm Masquerading as Acute Appendicitis

Dimitrios A Chatzelas  1 , Stefanos K Atmatzidis  1 , Maria D Velikoudi  1 , Vasileios Papaziogas  1
Affiliations
Case Reports

Ruptured Abdominal Aortic Aneurysm Masquerading as Acute Appendicitis

Dimitrios A Chatzelas et al. Cureus. .

Abstract

Ruptured abdominal aortic aneurysm (AAA) is a life-threatening emergency with high mortality. Its presentation is often atypical and may mimic more common abdominal conditions. We report the case of a 65-year-old man who presented with acute right lower quadrant pain initially suggestive of acute appendicitis. However, computed tomography (CT) revealed a large infrarenal AAA with a contained rupture. This atypical presentation highlights the importance of including AAA in the differential diagnosis of elderly patients with abdominal pain. Early imaging, particularly CT, is essential to differentiate AAA from other causes of acute abdomen and to prevent diagnostic delays. Maintaining a high index of suspicion is critical for timely recognition and improved outcomes.

Keywords: abdominal aortic aneurysm; acute appendicitis; differential diagnosis; endovascular repair; rupture.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Computed tomography angiography showing an infrarenal abdominal aortic aneurysm measuring 70 mm in maximum diameter, with a contained rupture and associated retroperitoneal hematoma (estimated volume: 760 mL)
Figure 2
Figure 2. Postoperative computed tomography angiography showing the bifurcated abdominal aortic stent-graft in place, without evidence of endoleak
See this image and copyright information in PMC

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