23826              RUPTURED ATHEROSCLEROTIC ABDOMINAL AORTIC ANEURYSM

The patient was a man aged 80 who was under treatment by oestrogens for carcinoma of the prostate. He suddenly became comatose with dilated pupils and did not respond to painful stimuli. The B.P. was not recordable, but the femoral pulses were recorded as strong, 100/minute and regular. A mass could be felt in the left hypochondrium. He died 4 hours after the onset of the collapse. At postmortem there was some senile atrophy in the brain with status lacunatus in the basal ganglia but no large focal lesion. A massive retroperitoneal haematoma extended from the diaphragm to the iliac fossa, originating from an aneurysm of the abdominal aorta.

The specimen shows this aneurysm. It is spheroidal and measures 10 x 7 x 7 cms. Its lumen is largely filled with antemortem thrombus. There is fatty and ulcerative atherosclerosis of the aorta above the aneurysm and there is marked degeneration of the wall of the iliac artery below the aneurysm.