The patient, male, 38 years old, was transferred from an outside hospital with sudden onset of chest and back pain for 19 hours. On admission, the patient had a blood pressure of 200/120 mmHg, abdominal distension, disappearance of bilateral femoral artery pulsations, and low skin temperature of bilateral lower extremities covered with florid patches. 2 hours later, he was treated surgically. Acute renal failure developed early after surgery and recovered after hemofiltration. Preoperative photos Postoperative photos