Introduction:
An aortic aneurysm with the diameter of more than 10 cm is considered giant. TAAAs without treatment can be life-threatening. In these cases, the rupture has high mortality and its risk is approximately 60% [1, 2]. 43% of all TAAAs are asymptomatic and discovered accidentally during radiologic investigations for an irrelevant cause. Among other 57% of cases, which are symptomatic, 9% become symptomatic when the aneurysm ruptures. Pulsetile mass in the abdominal wall is the specific symptom of aortic aneurysm; however, other symptoms are non-specific and caused by extrinsic compression of the giant aneurysm into the surrounding structures. Giant aneurysms can compress the gastrointestinal tract and cause an obstruction with symptoms including vomiting, constipation, abdominal distention, and pain.[1,3] This article reports a case with symptoms of abdominal pain, nausea, vomiting, and oral intake intolerance in the past 4 days before admission, and moreover with protruded abdomen with pulsation. In radiologic investigations, a giant thoracoabdominal aortic aneurysm (TAAA) with chronic contained leak and acute rupture within the circumferential mural thrombus were observed. The patient was resuscitated, transferred to emergency operation room, and underwent aorto-renal reconstruction surgery.