A 75-year-old male with a history of smoking and high cholesterol presents with sudden onset of severe abdominal pain and back pain. Physical examination reveals a pulsatile mass in the abdomen. What could be the potential diagnosis, and what are the next steps?
The presentation of sudden, severe abdominal and back pain along with a pulsatile abdominal mass in a patient with risk factors for atherosclerosis is concerning for abdominal aortic aneurysm (AAA) rupture. This is a life-threatening emergency that requires immediate surgical intervention. A quick bedside ultrasound or CT scan can confirm the diagnosis if the patient's hemodynamic status allows.