Small abdominal aortic aneurysm rupture is uncommon and fatal. We report a case of twice sealed-rupture small abdominal aneurysm 3.5 cm in diameter. Computed tomography showed unusual findings of a hematoma-like multiple cyst around the small aneurysm. We were bothered the diagnosis. By the intraoperative finding; an irregular pseudoaneurysm, the final diagnosis was performed. After aneurysmectomy, artificial graft replacement was made. From only this case, discussion of the indications for the small abdominal aortic aneurysm is difficult. However, the possibility of the rupture in even this [correction of thus] small abdominal aortic aneurysm should be considered.
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