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What Happens When An Aortic Aneurysm Ruptures?

Ruptured form of aortic aneurysm is a fatal type of surgical emergency and it has overall mortality rate equal to 90percent. Most of the aortic aneurysm ruptures within the retroperitoneal cavity leading to classical pain triad, hypotension and pulsatile type of mass. However, according to the latest research report, different aortic aneurysm rupture sites in patients indicate a wide range of uncommon and common clinical presentations. Hence, when doctors recognize it early, it may save the life of many people.

What Happens When An Aortic Aneurysm Ruptures?

Anterior Intra Peritoneal Rupture: In case of anterior intra peritoneal rupture, you will observe a small tear in the aneurysm’s anterior wall and a sudden as well as a severe back/abdominal pain and collapse. Moreover, the resultant bleeding within the peritoneal cavity becomes so rapid that it leads to exsanguinations or even death and that too before the patient admits in a hospital.

Posterior Retroperitoneal Rupture: Posterior retroperitoneal rupture or a tear in the wall of posterolateral aneurysm results in retroperitoneal bleeding, while it manifests as severe back pain and with or without any other problem, such as hypotension or abdominal pain. However, the tear in this case may remain in sealed condition for some time to give some time for the patient to transfer to the hospital and undergo with the necessary diagnosis and treatment procedure.

Chronic form of Ruptured Aortic Aneurysm: Despite a majority of patients dealing with the problem of ruptured aortic aneurysm deal with acute presentation, a few patients may escape detection for about weeks or months after the rupture of aneurysm takes place. This usually takes place whenever retroperitoneal rupture results in slow progressive bleeding to form a big haematoma contained via periaortic tissues resistance.

Rupture within the Abdominal Veins: In rare cases, abdominal aortic aneurysm ruptures within the left renal vein or inferior vena cava, which further results in the fistula of aorta-left renal vein or the aorto-caval respectively.

Aortocaval Fistula Rupture: Spontaneous form of aortocaval fistula takes place commonly whenever any aortic aneurysm erodes or ruptures within the inferior vena cava. In patients dealing with the problem of aortocaval fistula, manifestations of rupture mainly dominate its clinical picture diminish any chance related to preoperative diagnosis in a significant way.

Manifestations in this case are even variable, as they depend primarily on the communication size in between the inferior vena cava and the aorta. Therefore, permanent or temporary closure of this communication via any aortic mural thrombus or compression of aneurysm will bring changes in the clinical picture.

Aorta–Left Renal Vein Fistula Rupture: According to doctors, aorta–left renal vein fistula is one of the extremely rare conditions with less than 26 cases. This problem usually takes place whenever the wall of any infra-renal wall belonging to aortic aneurysm erodes within the left renal vein. This vein usually crosses in front of any abdominal aorta on the way towards the inferior vena cana. Haematuria, abdominal pain, silent syndrome in the left kidney are a few primarily clinical features associated with the problem of aorta–left renal vein fistula.

Aortoenteric Fistula: Aortoenteric Fistula or rupture within the bowel implies an abnormal type of communication taking place in between the bowel and the abdominal aorta. The problem may be of primary or of secondary. Any primary type of aortoenteric fistula connects infra renal aortic aneurysm towards the bowel and commonly the duodenum. Secondary form of aortoenteric fistula constitutes the late postoperative type of complication and it takes place because of erosion in the prosthetic aortic graft present within the duodenum.


  1. UpToDate. (2021). Ruptured abdominal aortic aneurysm. https://www.uptodate.com/contents/ruptured-abdominal-aortic-aneurysm
  2. Journal of Clinical Medicine Research. (2018). Diagnosis and Treatment of Ruptured Abdominal Aortic Aneurysms. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6222747/
  3. Journal of Cardiothoracic Surgery. (2015). Ruptured abdominal aortic aneurysm. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4345353/

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Team PainAssist
Team PainAssist
Written, Edited or Reviewed By: Team PainAssist, Pain Assist Inc. This article does not provide medical advice. See disclaimer
Last Modified On:July 24, 2023

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