Psoas weakness and femoral neuropathy: neglected signs of retroperitoneal hemorrhage from ruptured aneurysm.

Femoral neuropathy may occur with aortic aneurysm more commonly than reports in the literature indicate. The combination of an aortic aneurysm and femoral neuropathy indicates rupture. The presence of abdominal pain and neuropathy should suggest ruptured aneurysm and exclude other commonly considered diagnoses. Preoperative recognition of femoral neuropathy provides the opportunity for intraoperative nerve decompression and assures the surgeon that the operation itself was not causative. The literature is reviewed, and the preoperative occurrence of femoral neuropathy in two patients with ruptured aortic aneurysms is described.