Z.1.11 Ruptured abdominal aortic aneurysm in a patient with complicated atherosclerosis

A 77 -77-year-old male with a known history of chronic hypertension presented with chest pain, shortness of breath and an altered level of consciousness for a few hours duration. On clinical examination he was pale. An ultrasound scan revealed the presence of a large intra-abdominal mass with no free fluid. He deteriorated rapidly,developed a cardiac arrest and died  five  hours following the admission.

The specimen shows the open out abdominal aorta with dilatation starting just below the renal ostia and extending down to the bifurcation. There is a large haematoma formation with luminal thrombus.  The rest of the abdominal aortic wall and thoracic aorta showed complicated atherosclerotic plaques with ulceration and calcification. There was no narrowing of renal artery ostia.