Bilateral spontaneous dissecting common iliac artery aneurysms: a rare presentation

Spontaneous iliac artery dissection is a rare clinical entity, reported previously in pregnant patients in association with collagen vascular disease, and in cases of high-energy trauma or intensive activity in athletes.

To alert clinicians to the incidence of spontaneous iliac artery dissection in the absence of any risk factors.

We report a case of a 45-year-old man brought into the Emergency Department with severe lower abdominal pain. Computed tomography angiography revealed bilateral common iliac artery dissecting aneurysms with a dissection flap extending into the left internal iliac artery.

This case demonstrates that despite being a rare condition, in cases of acute lower abdominal, inguinal or lower back pain, even in the absence of risk factors and limb ischemia, emergency physicians should maintain a broad differential that includes intra-abdominal/pelvic vascular pathology such as iliac artery dissection.