Ruptured mycotic abdominal aortic aneurysm with perforated colonic malignancy - "Quadruple Jeopardy"

We describe an unusual presentation where a patient referred for ruptured abdominal aortic aneurysm was detected to have a concurrent colonic growth with perforation and localized spillage. Aneurysm repair was done with neoaortoiliac system reconstruction and Hartmann's procedure was done. This case report describes the management of a rare intraoperative challenge.