Eur J Vasc Endovasc Surg 21, 84–87 (2001) doi:10.1053/ejvs.2000.1253, available online at http://www.idealibrary.com on CASE REPORT Pregnancy–puerperium-related Rupture of Abdominal Aortic Aneurysm E. Sima ˜ o da Silva* 1 , F. L. Tozzi 2 , E. C. Magalha ˜ es Tolosa 1 , F. M. Duch 1 , J. Chiang 1 and L. M. Machino 1 1 Department of Surgery, Sa ˜o Paulo University School of Medicine, 2 University Hospital, University of Sa ˜o Paulo, Brazil Introduction delivery, the pain severely worsened. There was no history of syphilis, endocarditis, tuberculosis, or use Reports of abdominal aortic aneurysms associated of injectable drugs. She came to the emergency room with intense back pain and diffuse abdominal pain and with pregnancy and the puerperium are rare. 1–4 They are normally associated with acute arterial dissec- hypotension. Blood analysis revealed a haemoglobin of 10.3, haematocrits of 33%, and leukocytes of 6700. tions, 5 and aneurysms of the splenic, 6,7 cerebral 6 and renal arteries. 4,6 Abdominal ultrasonography showed fluid in the ab- dominal cavity but failed to demonstrate any masses. We present a patient with a ruptured abdominal aortic aneurysm during the puerperium and review The surgical team performed a laparotomy and dis- covered intraperitoneal blood and a retropancreatic of the literature. pulsatile mass, with a surrounding haematoma. The team suspected a thoracoabdominal aneurysm and Case Report decided to close the laparotomy and refer the patient to a vascular surgeon. An urgent CT scan (Fig. 1) A 36-year-old woman began experiencing left lumbar demonstrated a suprarenal aortic aneurysm with con- and back pain during the last trimester of her third tained rupture or a pseudoaneurysm. Through a pregnancy. After a full-term pregnancy and normal Fig. 1. Preoperative CT scan showing the saccular suprarenal abdominal aortic aneurysm and the haematoma surrounding it. * Please address all correspondence to: E. Sima ˜o da Silva, Rua Martins 96, Sa ˜o Paulo, Brazil. 1078–5884/01/010084+04 $35.00/0  2001 Harcourt Publishers Ltd.