CASE HISTORY

Patient has had abdominal pain for twenty years. Pain occurs shortly after food and has been getting worse recently. Two days before admission pain became severe, of intermittent character. No vomiting. Bowels constipated. On examination he was in evident pain. The abdomen was distended, and tenderness was general, but maximal in the right iliac fossa. Patient refused operation, became comatose and died.

PATHOLOGY

The specimen consists of the lower part of the abdominal aorta and the common iliac arteries. Just above the bifurcation there is a saccular aneurysm about the size of a hen's egg. This aneurysm is occurring in a portion of the wall which has been weakened by a considerable degree of atheromatous ulceration.