Unusual presentations of aortoiliac aneurysms

Unusual presentations of aortoiliac aneurysms may be the reason for a delay in diagnosis of potentially life-threatening conditions. Five such unusual clinical pictures are presented and discussed. The aneurysms were falsely diagnosed as malignant disease, renal colic, sciatic syndrome, intra-abdominal bleeding of unknown origin, and psoas muscle abscess. The medical staff was misled by the atypical complaints, signs and symptoms, which resulted in a dangerous delay in diagnosis. The use of currently available ultrasonography and CAT scans, which enables early diagnosis, depends on the alertness of clinicians when they confront an atypical clinical picture that may be the first clue of a noninnocent aneurysm of the aortoiliac complex. Early surgical intervention before dissection, rupture or fistulization occur ensures a positive outcome and avoids emergency procedures with their attendant high operative mortality and postoperative morbidity.