What vascular emergency involves weakening of the abdominal aorta wall that can rupture, causing tearing back pain and a pulsating abdominal mass, especially in geriatric males?

• A. Esophageal varices
• B. Abdominal aortic aneurysm
• C. Ulcers
• D. Kidney stones

Answer: (B)

Abdominal aortic aneurysm is a dilation and weakening of the abdominal portion of the aorta. The wall thins and can rupture, leading to life-threatening internal bleeding. The scenario fits older men who have risk factors like atherosclerosis and hypertension. When it ruptures, patients often describe sudden, severe back or abdominal pain that may feel tearing, and a pulsating feeling in the abdomen can be present. Because rupture can cause rapid blood loss and shock, it’s a true emergency requiring immediate transport to a facility capable of surgical repair. Other conditions listed don’t fit this picture: esophageal varices involve upper GI bleeding, ulcers cause abdominal or epigastric pain without a pulsatile mass, and kidney stones cause intense flank or groin pain without a pulsatile abdominal mass or tearing.