A patient describes a sudden onset of severe, constant abdominal pain radiating to the lower back. What do you suspect?

The presentation of sudden onset of severe, constant abdominal pain that radiates to the lower back is characteristic of an abdominal aortic aneurysm (AAA). This condition occurs when there is a dilation or bulging in the wall of the aorta, which can lead to tearing or rupture. The severe pain is often described as sharp and may be felt in the abdomen and back due to the anatomy of the aorta and its branches supplying blood to both regions.

Patients with an AAA may also exhibit other signs such as hypotension, a pulsating mass in the abdomen, or signs of internal bleeding if a rupture occurs. The nature and site of the pain are key indicators, making the description fit the classic presentation of an AAA.

In contrast, other conditions such as intestinal obstruction typically present with cramping pain that may be intermittent, rather than a constant severe pain. Esophageal varices are usually associated with liver disease, presenting more with upper gastrointestinal bleeding rather than abdominal pain radiating to the back. An ulcer may cause abdominal pain but typically presents with episodic pain and is more localized to the stomach area than radiating to the back. Thus, the symptoms and their characteristics strongly align with an abdominal aortic aneurysm as the most probable condition in this