The authors report a new case of spontaneous rupture of an infrarenal abdominal aortic aneurysm into the inferior vena cava operated with a good haemodynamic result. However, the patient died of multiple postoperative complications and an associated left bronchopulmonary carcinoma. The following features are emphasised: the contribution of complementary investigations to the diagnosis of this condition: abdominal ultrasonography, aortography and above all, especially in future years, of digitised angiography; the clinical importance of ischaemia of the descending colon and acute postoperative renal failure, the prevention of which should improve surgical results.