A 70-year-old male with a history of smoking and hypertension presents with sudden severe back pain that radiates to the lower abdomen. He has a pulsatile mass in his abdomen and hypotension. What's the likely diagnosis and the next steps?
The patient's symptoms suggest a ruptured abdominal aortic aneurysm, a life-threatening condition. The next steps include stabilizing the patient with intravenous fluids, controlling blood pressure, and arranging immediate surgical intervention, either open surgical repair or endovascular aneurysm repair depending on the patient's stability and local resources.