Rupture of an abdominal aortic aneurysm is readily diagnosed when the triad of abdominal or back pain, shock and a pulsatile abdominal mass are present. Clinical diagnosis can be difficult, however, when patients present with chronic pain and an aneurysm which is not readily palpable. In these patients with confusing abdominal symptoms, CT scan provides a rapid, noninvasive diagnosis. The acute leaking AAA has been documented, but only rarely. This report identifies two patients who ruptured an aortic aneurysm several "months" prior to operation--a "contained chronic" rupture.
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