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Case Reports
. 2025 Jun 2;20(1):255.
doi: 10.1186/s13019-025-03474-y.

Unusual onset and presentation of isolated Uni-iliac aneurysm dissection in presence of aortoiliac aneurysms

Muhamad Zakaria Brimo Alsaman  1   2 , Abdo Mohamad Zain  3 , Rawan Al-Deeb  4 , Mohammed Hamdan  3 , Ghaiyath Khalil  3 , Hussein Alkanj  3
Affiliations
Case Reports

Unusual onset and presentation of isolated Uni-iliac aneurysm dissection in presence of aortoiliac aneurysms

Muhamad Zakaria Brimo Alsaman et al. J Cardiothorac Surg. .

Abstract

Introduction: The dissection of the iliac artery aneurysm is considerably rare, with limited documentation in the existing literature. Iliac artery dissection can be attributed to several causative factors, including trauma, pregnancy, athletic activity, arterial catheterization, and connective tissue disorders.

Case presentation: This case reports a 72-year-old male complaining of pain in the right iliac fossa and hypogastric region, radiating to the back. An abdominal ultrasound revealed a right dissected common iliac aneurysm, left common iliac aneurysm and an abdominal aortic aneurysm. Further investigation confirmed the same findings. Several hours later, the decision of emergency surgery was done due to signs of hemorrhagic shock caused by ruptured unilateral iliac aneurysm. The aneurysms were successfully repaired by aorto-bi-iliac dacron-graft bypass and palpable femoral pulses noted at the end of the surgery.

Conclusion: Close monitoring of these patients is crucial due to the significant morbidity associated. Early intervention may be necessary, particularly before any signs of deterioration and hemorrhagic shock.

Keywords: Abdominal aortic dissection; Aortic aneurysm; Dissection; Iliac aneurysm; Ruptured.

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Conflict of interest statement

Declarations. Ethics approval and consent to participation: Not required for case reports at our hospital. Single case reports are exempt from ethical approval in our institution. Consent for publication: Consent for publication was obtained from the patient’s parents for publication of this case report and accoupling images. A copy of the written consent is available for review by the Editor -in -Chief of this journal on request. Declaration of AI and AI-assisted technologies in the writing process: During the preparation of this paper, the authors used the assistance of Microsoft Copilot in order to proofread the manuscript for any grammar and spelling mistakes. After using this tool, the authors reviewed and edited the content as needed and take full responsibility for the content of the publication. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Preoperative duplex showing the intimal tear in the dissecting right common iliac aneurysm (white arrow), causing intramural hematoma (black arrow)
Fig. 2
Fig. 2
Contrast- enhanced MSCT (A) with 3D reconstruction (B) showing abdominal aortic aneurysm (red arrow), along with dissected aneurysm in the right common iliac artery (white arrow), and a left common iliac aneurysm (yellow arrow)
Fig. 3
Fig. 3
Intraoperative image shows abdominal aortic aneurysm (black arrow), along with retroperitoneal ruptured right common iliac artery aneurysm (white arrow) and left common iliac artery aneurysm (yellow arrow)
Fig. 4
Fig. 4
An aorto-bi-iliac bypass, by using bifurcated dacron graft, was performed. The graft was anastomosed proximally to infrarenal aorta (black arrow), then the right limb anastomosed to the right common iliac artery (white arrow) and the left limb anastomosed to the left external iliac artery (yellow arrow)
See this image and copyright information in PMC

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