Similar story to the above during a weekend call to an approximately 45 year old male. The presenting complaint was lower back pain since two days with some radiation to the legs, no signs for neurologic or muscular origin, normal pulse and BP, slightly elevated temperature, no mass palpable in his abdomen or groin although some pain was inflicted by deep midabdominal palpation. Normal urine sample. Non-smoker, not obese, no relevant history. He was also pacing around the room and the pain hadn't responded to a dose of morphine given by antoher GP the night before, we were the third GP visiting in those 48 hours. Consulted a vascular surgeon who stated that it couldn't be a ruptured AAA due to the fact that he was already having symptoms for two days and was hemodynamically stable, he thought that it could be diverticulitis. Nevertheless sent him to the hospital with a note stating the suspicion of an AAA, radiologist was unpleasantly surprised to see a dissection of the aorta from the bifurcation up to the thoracal part... He actually survived the following surgery and was back at home in two weeks. Although he had lower back pain there were no other symptoms pointing in the direction of an AAA besides the pacing and the non-response to analgesia.