External iliac vein aneurysm: a case report and review of the literature

Abstract

Iliac vein aneurysms are extremely rare, even amongst vein aneurysms. We discuss the case of a 26-year-old man with an external iliac vein aneurysm, likely secondary to iatrogenic vascular trauma in the neonatal period. It is the first reported case of an iliac vein aneurysm presenting with lower urinary tract symptoms. Attempts at endovenous management were unsuccessful and therefore the patient underwent open aneurysmectomy. A PubMed literature search revealed a total of nine case reports of iliac vein aneurysms published in English since 2011. We discuss the aetiology, presentation, investigation and management of iliac vein aneurysms and compare to our own case.

Figure 1:

CT scan demonstrating right iliac vein aneurysm (5.7 cm) (red arrow) compressing the patient’s full bladder.

Figure 2:

Intra-operative appearance of the external iliac vein aneurysm. A retroperitoneal approach was used via a Rutherford-Morrison incision. Laterally, the external iliac artery is controlled with a vessel loop.

Figure 3:

Clamped external iliac vein aneurysm.

Figure 4:

Intra-operative appearance post aneurysmectomy.

Figure 5:

Post-operative CT scan demonstrating no evidence of residual aneurysm, or bladder compression. A residual dilated and tortuous collateral vessel remains communicating between the right internal iliac vein and right common femoral vein (red arrow).