This is a 58-year-old male patient with hypertension of more than 10 years of evolution, treated but not controlled.
As a relevant pathological history the patient had noticed a palpable and pulsatile abdominal mass in the last month.
Ten days before admission to our center, the patient developed severe abdominal pain.
Abdominal computed tomography showed the presence of an infrarenal aortic aneurysm, with an inflammatory process that involves and adheres to the third portion of the duodenum.
The patient requested voluntary discharge following the surgical proposal.
The patient was readmitted to the Intensive Care Unit after five days of evolution due to upper gastrointestinal bleeding manifested by urinalysis and melena of 48 hours of evolution, hypovolemic shock, mean blood pressure of 140 bpm, hematocrit of 30 mmHg
Once the hemodynamic disorder was diagnosed, an upper gastrointestinal fibroscopy was performed, finding active bleeding in the posterior aspect of the third duodenal portion.
It was then decided to perform a surgical intervention due to massive rebleeding, with the intraoperative finding of saccular infrarenal abdominal aortic aneurysm adhered to the posterior aspect of the third duodenal portion with communication to the orifice of this organ 4 cm.
A bypass-bifemoral bypass was performed.
Due to the severe hemodynamic compromise, she presented cardiorespiratory arrest in the operating room and died a few hours later in the Intensive Care Unit.
