CASE STUDY 1

A 62-year-old man comes to the emergency department at 5 PM complaining

of left flank pain for approximately 2 hours. The pain started earlier the same
day, had become progressively worse, and was not relieved by changes in
position. The patient denied hematuria, dysuria, constipation, diarrhea, or
any recent trauma. He has a history of hypertension.

On presentation, the patient’s vital signs were stable; however, he appeared

in obvious discomfort. His initial vital signs are: HR 98, RR 24, BP 190/105,
Temp 37.3.
Results of his physical examination included clear lungs; a regular heart rate
and rhythm; and an obese abdomen that was soft and had mild distention.
There was pulsatile mass noted on light palpation of the abdomen with
considerable discomfort with pain radiating to his flank and back bilaterally.

GUIDE QUESTIONS

1. What are the salient features of the case? Discuss completely.

2. What specific structures are possibly affected in this case? Discuss in
detail.
3. Discuss the factors which may have caused the patient’s condition.
4. Discuss completely and correlate the anatomic basis of the signs and
symptoms of the patient.
5. Discuss the possible complications if this condition if left untreated.