Rupture of an aortic abdominal aneurysm presenting as painful obstructive jaundice

An unusual case of a ruptured abdominal aortic aneurysm is described. The patient presented with sudden abdominal pain and obstructive jaundice and was misdiagnosed as suffering from biliary colic. Two months later there was a pulsating mass in the abdomen palpated and the patient operated on. The only pathology which could explain the jaundice was an organized retroperitoneal hematoma extending from a small sealed rupture of the aneurysm towards the head of the pancreas and duodenum.