INTRODUCTION: Ruptured abdominal aortic aneurysm (RAAA) can infrequently present as symptomatic groin hernia. This misleading form of presentation often leads to erroneous preoperative management resulting in poor survival.
CASE PRESENTATION: Two patients with RAAA mimicking symptomatic groin hernia underwent different preoperative managements pointing out the importance of the principles of hypotensive haemostasis in the scope of this emergency scenario.
CONCLUSION: Computed Tomography Angiography (CTA) remains the recommended diagnostic tool-for both safe diagnosis of the ruptured aneurysm and precise preoperative planning. Endovascular aortic repair of the RAAA-if feasible-is the treatment of choice. This rare form of RAAA manifestation should call physicians attention-especially in patients with known abdominal aortic aneurysms in their preceding medical history.