Mortality in 100 patients undergoing resection of ruptured atherosclerotic aneurysms of the abdominal aorta was 58%. In addition to advanced age and concurrent cardiac disease, lethal factors included preoperative hypotension, cardiac arrest, anuria, and free intra-abdominal rupture. Failure to establish the correct diagnosis until the onset of these four signs contributed to the high mortality. (JAMA 233:147-150, 1975)