Abdominal aortic aneurysm rupture masquerading as strangulated inguinal hernia

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To the editor:

—The diagnosis of ruptured abdominal aortic aneurysm (AAA) is not uncommonly delayed or initially missed.1, 2, 3, 4, 5 Patients present with atypical manifestations, in the absence of the classical diagnostic triad of abdominal and back pain, hypotention, and a pulsatile abdominal mass. We report an elderly patient who at urgent inguinal exploration of a possibly strangulated left inguinal scrotal hernia was found to have inguinal extension of a retroperitoneal hematoma secondary to abdominal

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