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What is the most appropriate first step in managing this patient?
Initial bloods show that the patient’s Hb is 67 g/L (normal range 130-170). His observations stabilise after 2 units of blood, 1 unit of fresh frozen plasma, and 50 units per kg Beriplex.
Ultrasound of the aorta and abdomen show free fluid in the abdomen. The referring hospital’s clinical suspicion had been of leaking or ruptured AAA.
What is the most appropriate method to confirm this diagnosis?
A CT Aortogram is completed, which shows four quadrant haemoperitoneum. However, the known aortic aneurysm only measures 46mm, and whilst chronic dissection is seen, there is no evidence of any rupture.
Collateral from patient’s wife reveals that 1 week ago he had sustained a fall.
Based on this and the CT images below, what injury has the patient sustained?
