Abdominal aortic aneurysm rupture presenting as testicular pain

We report the case of a 74-year-old man who presented to our emergency department with complaints suggestive of a urinary tract disease. After examination failed to reveal another etiology for his symptoms, antibiotic therapy was initiated and the patient was discharged. He returned the next day with worsening pain; he was reevaluated and given an injection to control his pain. Thirty seconds later, the patient was unresponsive and pulseless and died despite resuscitative efforts. Autopsy revealed a ruptured abdominal aortic aneurysm. Our case highlights the varied presentations of abdominal aortic aneurysm, which often go unrecognized, and the need to diligently search for this life-threatening affliction.