Livedo Reticularis as a Manifestation of Abdominal Aortic Aneurysm

Abdominal aortic aneurysm is defined as the abnormal dilation of the abdominal aorta to a diameter of three centimeters or greater. The risk of rupture increases significantly when the aneurysm is greater than 6 centimeters in diameter. Ruptured abdominal aortic aneurysms carry a mortality rate of up to 83%, with up to a third of these deaths occurring before the patient reaches the hospital. Symptoms of dissection or rupture of the abdominal aorta include a tearing sensation in the back, lower extremity weakness, sudden and severe abdominal pain, and hypotension. Symptoms are often vague, and some patients have few symptoms until they develop hypotension and shock. In this case presentation, a 65-year-old male presented to the emergency department with sudden onset of leg weakness, and was noted to have a well demarcated livedo reticularis rash. A computed tomography scan showed a large abdominal aortic aneurysm with evidence of active hemorrhage within the aneurysm. He underwent surgical repair and was discharged in good condition.