Posteriorly ruptured abdominal aortic aneurism causing vertebral erosions

A 52-year-old black woman presented to the emergency department with a complaint of worsening lumbar pain during the last month. A report of untreated severe arterial hypertension was provided. She had been suffering from chronic lumbar pain for the previous 2 years. During the investigation of lumbar pain she had been diagnosed as having an abdominal aortic aneurism, but she declined treatment and follow-up. At presentation she was hemodynamically stable and had no signs of peritoneal irritation on physical examination. An abdominal computed tomography was performed and revealed a ruptured posteriorly blocked aortic aneurism, which caused severe erosions on the anterior vertebral bodies of L3 and L4. The patient was operated on the next day after admission, and an aneurysmal repair was performed. She was admitted to the ICU and evolved with shock, acute renal failure, mesenteric ischemia and multiple organ dysfunction. She died on the third day after hospital admission.

Figure 1

(abstract P103)