Abdominal aortic aneurysm is a segmental dilatation of the aortic wall that causes the vessel to be larger than 1.5 times its normal diameter or that causes the distal aorta to exceed 3 cm. This can continue to expand and can rupture spontaneously causing exsanguinations and even death ^[1].
Abdominal aortic aneurysm rupture is an important cause of unheralded deaths in people older than 55 years. The risk factors for aneurysm rupture are: the increased initial or the rapid growth of the aneurysm diameter, smoking, advanced age, male sex, lower forced expiratory volume, chronic obstructive pulmonary disease, hypertension, and family history. Abdominal aortic aneurysm rupture is more frequently produced in the left side ^{[1, 2].}
Clinically abdominal aortic aneurysm rupture may be an incidental discovery or the patient could present with abdominal, back or flank pain [1, 2].
X-Ray findings: A curvilinear calcified rim often to the left of the midline is apparent on some plain abdominal radiographs. Mural calcification can be radiographically unapparent and lead to a false-negative finding in as many as half of small abdominal aortic aneurysm ^{[1, 3].}
Unlike most other modalities (aortography, CT, MRI), abdominal ultrasound can be performed expeditiously and at the bedside. With partially encapsulated hematoma, a hypoechoic or anechoic para-aortic space-occupying lesion may be detected. Color-flow Doppler can aid in detecting the site of leak or extravasations, although adjustment to low-velocity scales may be necessary to register leaks with low flow rates ^{[3, 4, 5].}
CT findings that indicate possible abdominal aortic aneurysm rupture include soft tissue hyperdensity outside the aortic wall, an indistinct aortic wall, thinning or fracture of a calcified aortic wall segment, penetration of a hematoma into the leaves of the mesentery, or extravasation of contrast into the psoas muscle or retroperitoneum, enlargement or obscuration of the psoas muscle, and anterior displacement of the kidney ^{[1, 5, 6].}
MRI is a valuable alternative to CT in patients with renal insufficiency in who contrast material–induced nephropathy is a concern. MRI is also helpful in further delineating the aorta in the context of a large retroperitoneal collection that obscures the borders between adjacent structures, as well as laminated clot or atherosclerotic debris on the aneurismal wall ^[7].
Angiographically a circumscribed extraluminal contrast enhancement is seen. In case of leaking aneurysm the frank extravasation of contrast material with poor washout is observed. This is rarely demonstrated because the patients are typically in unstable condition and are transported directly to the operating room ^{[1, 3].}
Abdominal aortic aneurysm rupture, symptomatic expansion, or sentinel leak is a surgical emergency. Endovascular reparation with graft placement with or without hypo gastric or internal iliac artery embolization represents a surgical option ^{[1, 3]}

The ultrasound examination was performed using Medison Kretz SonoAce 8800 equipment with 3.5-5 MHz curved transducer.