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Bilateral spontaneous dissecting common iliac artery aneurysms: a rare presentation
Kevin D Goodman1, Harsh P Sule
1Department of Emergency Medicine, Thomas Jefferson University & Hospitals, Philadelphia, PA 19106, USA.
The Journal of Emergency Medicine
|January 15, 2013
Summary
Spontaneous iliac artery dissection is a rare vascular condition. Emergency physicians should consider it in patients with severe abdominal or back pain, even without typical risk factors.
Area of Science:
- Vascular Surgery
- Diagnostic Imaging
- Emergency Medicine
Background:
- Spontaneous iliac artery dissection (SIAD) is a rare condition.
- Previously reported in pregnant patients, with collagen vascular disease, or following trauma/intense activity.
- This study aims to highlight SIAD incidence without apparent risk factors.
Observation:
- A 45-year-old male presented with severe lower abdominal pain.
- Computed tomography angiography revealed bilateral common iliac artery dissecting aneurysms.
- Dissection flap extended into the left internal iliac artery.
Findings:
- The case highlights a spontaneous iliac artery dissection in a patient without typical risk factors.
- Diagnosis was confirmed via computed tomography angiography.
- The dissection involved bilateral common iliac arteries and the left internal iliac artery.
Implications:
- Emergency physicians must include iliac artery dissection in the differential diagnosis for acute lower abdominal, inguinal, or lower back pain.
- Consideration is crucial even in the absence of risk factors or limb ischemia.
- This emphasizes the need for a broad differential for intra-abdominal/pelvic vascular pathology.
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