espanolLa rotura de un aneurisma aortico abdominal (AAA) es un evento altamente letal que continua asociada a una alta mortalidad, a pesar de su disminucion en las ultimas dos decadas, asociada a la adopcion de la cirugia endovascular como primera linea de tratamiento y a avances en el manejo anestesico y perioperatorio. La actuacion frente a un AAA roto (AAAr) puede dividirse en cuatro etapas: diagnostico, manejo perioperatorio, cirugia y posoperatorio. En el marco de las guias americana y europea sobre manejo de AAAr y de la Guia NICE, se expone una actualizacion de los puntos criticos en cada etapa: desde el papel diagnostico clave del angio-TAC hasta el manejo de complicaciones posoperatorias, como el sindrome compartimental abdominal. La creacion de protocolos y algoritmos basada en la evidencia ayuda en la toma de decisiones y disminuye el tiempo desde el diagnostico hasta el control hemorragico, esencial para la supervivencia EnglishA ruptured abdominal aortic aneurysm (rAAA) is a highly lethal event remaining associated with a high overall mortality, in spite of the reduction in the mortality from rAAA over the last two decades linked with the adoption of an endovascular aneurysm repair (EVAR) as the forefront strategy, as well as the advances in perioperative critical care practices. Management of a rAAA can be divided into four stages: diagnosis, perioperative management, surgical repair and postoperative period. Within the framework of American and European clinical practice guidelines on the management of abdominal aortic aneurysms and NICE guideline, all of them recently published, updated critical issues for each stage are shown. From the key role of CT angiogram for the diagnosis to the postoperative complications, such as abdominal compartment syndrome The creation of evidence-based protocols and algorithms for rapid diagnosis and treatment aids to make decisions and at the same time it will reduce the time since diagnosis to control of hemorrhage, which is essential for survival.