Abdominal aortic aneurysms present a difficult diagnostic problem when they rupture into the retroperitoneal space. Frequently the diagnosis is made only at operation or at death. Symptoms and signs may mimic an acute surgical abdomen and may suggest a perforated viscus, renal calculus, retroperitoneal abscess, strangulated hernia, or mesenteric vascular occlusion.1,2,3 With the advent of homograft replacement, not only have intact abdominal aortic aneurysms been repaired, but ruptured ones have as well.4 This fact, coupled with the fact that there is often a significant time interval from the onset of leaking to ultimate rupture, make it important to recognize this entity. The case presented below is unusual in that there were few abdominal symptoms and that the slowly leaking aneurysm ran a clinical course compatible with an infection or fever of undetermined etiology.
Report of Case
A 66-year-old single white man was admitted for the first time to