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.