[Not all low back pain is renal colic]

Area of Science:

• Vascular Surgery
• Cardiology
• Primary Care Medicine

Background:

• Low back pain is a prevalent primary care complaint with a broad differential diagnosis.
• Differentiating serious pathologies from common musculoskeletal causes can be challenging.
• Aortic syndromes, though rare, can present with back pain, necessitating timely diagnosis.

Observation:

• A 59-year-old female with dyslipidemia presented with breakthrough low back pain.
• Initial presentation mimicked common causes of back pain, complicating diagnosis.
• Diagnostic workup revealed a penetrating ulcer of the abdominal aorta.

Findings:

• The patient's low back pain was ultimately attributed to a penetrating ulcer of the abdominal aorta.
• Endovascular treatment was successfully employed by the vascular surgery service.
• This case underscores the critical need for a comprehensive diagnostic approach.

Implications:

• Highlights the potential for aortic syndromes to present atypically in primary care.
• Emphasizes the importance of considering vascular emergencies in the differential diagnosis of back pain.
• Demonstrates the efficacy of endovascular repair for penetrating aortic ulcers.