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November 1969

Perianal Ecchymosis as a Clinical Sign: Manifestation of Rupture of an Aneurysm Into the Sigmoid Mesocolon

Author Affiliations

Providence, RI
From the Department of Surgery, Rhode Island Hospital (Drs. Tamvakopoulos and Corvese), and the Division of Biological and Medical Sciences, Brown University (Dr. Vargas), Providence, RI.

Arch Surg. 1969;99(5):612-614. doi:10.1001/archsurg.1969.01340170064014

Although rupture of an aneurysm of the abdominal aorta is usually manifested by alarming symptoms—severe and often-excruciating back or abdominal pain, sudden in onset, associated with nausea and vomiting, hypertension, tachycardia, and peripheral vasoconstriction—the correct diagnosis is only too often not considered.1

The condition if not early properly diagnosed and treated is almost universally fatal. Half of the patients can survive, if operated upon promptly. Great emphasis should therefore be placed on early diagnosis and treatment.2,3

Quite often the symptoms may be atypical and are attributed to perforated ulcer, cholecystitis, biliary colic, pancreatitis, urethral stone, ruptured intervertebral disk, or exacerbation of chronic arthritis of the spine.2,3

Rupture of the aneurysm may occur into the retroperitoneal space, into the small bowel, quite often the duodenum—when it is manifested as exanguinative upper intestinal hemorrhage, into the inferior vena cava, or into the sigmoid mesocolon. Consequently, symptomatology varies according to