Abstract
The prevalence of internal iliac artery aneurysms (IIAA) is very low. Existing data on IIAA are scarce and mainly based on case reports and small retrospective series. We present the case of a 55-year-old African American man with a past medical history of HIV, hypertension, pulmonary embolism (PE), chronic obstructive pulmonary disease (COPD), coronary artery disease, polysubstance abuse, schizophrenia, depression, and bipolar disorder who presented to the emergency department with dyspnea on exertion. He was admitted for COPD exacerbation. He reported concerns of ambulatory chronic right hip pain, for which he underwent a CT, which revealed the presence of a partially visible right IIAA. A CT of his abdomen/pelvis revealed multiple aneurysms, including a partially thrombosed 8-cm fusiform right IIAA. Due to the presence of multiple aneurysms, the vascular surgery team was consulted, and elective repair was recommended. IIAA should be considered in the differential diagnosis of patients with significant smoking history and hip pain and acted upon immediately.
Highlights
Internal iliac artery aneurysms (IIAA) are a rare condition with an estimated prevalence of 0.03%, representing 0.3% of all aortoiliac aneurysms; 70% of iliac aneurysms occur in the common iliac artery, and only 20% and 10% occur in the internal and external iliac arteries respectively [1]
We present the case of a patient with exacerbated chronic obstructive pulmonary disease (COPD) with subsequent incidental findings of multiple diffuse aneurysms, including a rare, partially thrombosed 8-cm IIAA
A review of systems was significant for atraumatic ambulatory chronic right hip pain, which worsened with hip flexion
Summary
Internal iliac artery aneurysms (IIAA) are a rare condition with an estimated prevalence of 0.03%, representing 0.3% of all aortoiliac aneurysms; 70% of iliac aneurysms occur in the common iliac artery, and only 20% and 10% occur in the internal and external iliac arteries respectively [1]. We present the case of a patient with exacerbated chronic obstructive pulmonary disease (COPD) with subsequent incidental findings of multiple diffuse aneurysms, including a rare, partially thrombosed 8-cm IIAA. A 55-year-old African American man reported to the emergency department (ED) with concerns of exertional dyspnea He was in respiratory distress and demonstrated labored breathing. The patient reported drinking alcohol daily, smoking cigarettes daily (10 cigarettes per day for 25 years), along with daily marijuana and cocaine use His family history was pertinent for paternal lung cancer, maternal cerebrovascular accident, and heart disease in his sister. In the ED, he received three rounds of DuoNeb® (ipratropium bromide and albuterol sulfate) inhalation solution, 125 mg intravenous methylprednisolone, and 25 mg subcutaneous terbutaline His chest X-ray showed no active pulmonary disease. Note that bifurcation of the artery has not occurred on the left side, where both left internal and external iliac arteries are visible
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