A 65-year-old male with a history of hypertension and smoking presents with severe abdominal and back pain. A CT scan confirms a ruptured abdominal aortic aneurysm (AAA). What is the most appropriate next step in management? A) Endovascular aneurysm repair (EVAR) B) Open surgical repair C) Beta-blockers and blood pressure control D) Observation and serial imaging Answer: B) Open surgical repair Explanation: A ruptured AAA is a surgical emergency with a high mortality rate. Immediate open surgical repair is the preferred approach if the patient is hemodynamically unstable. EVAR may be considered in select stable cases, but open repair remains the gold standard for unstable patients. Observation and medical management are only used for small, unruptured AAAs.
