[Spontaneous rupture of left external iliac vein--a case report]

Spontaneous rupture of iliac vein is rare, and only twelve Caucasian cases have been reported. To our knowledge, this is the first reported case in Japan, and the thirteenth in the world. An 80-year-old female complained of sudden pain in the left flank as she passed stools and then collapsed. At the emergency laparotomy, a large retroperitoneal hematoma was encountered and a tear of 2cm length was found in the left external iliac vein with fresh intravenous thrombus. After a complete thrombectomy, the rent was sutured and her postoperative course was uneventful. The surgeon should consider the possibility of spontaneous vein rupture in the differential diagnosis with the patient presenting hypovolemic shock of unknown cause, which is often accompanied by abdominal tenderness, particularly when the patient is a middle age female, and the lesion is on the left side.