Abstract
Rupture is a rare but disastrous complication of an arterial aneurysm. Intraabdominal abscess in association with iliac artery aneurysm is uncommon but can predispose to aneurysm rupture. We report the Computed Tomography (CT) findings of an internal iliac artery pseudoaneurysm formed by a pelvic abscess attributed to the perforation of the patient’s Hartmann’s pouch. Rupture of the pseudoaneurysm resulted in the patient’s death.
Highlights
We report the Computed Tomography (CT) findings of an internal iliac artery pseudoaneurysm formed by a pelvic abscess attributed to the perforation of the patient’s Hartmann’s pouch
The Hartmann procedure is a relatively common surgery in which a diverting end-colostomy is created and the rectal stump is closed with suture (Hartmann’s pouch)
Lower gastrointestinal bleeding related to iliac artery aneurysm rupture or fistula formation into bowel has been previously reported, this case is different because the patient had a Hartmann’s pouch leak causing abscess and resulting in pseudoaneurysm formation [5,6,7]
Summary
The Society of Vascular Surgery and the North American Chapter of the International Society of Cardiovascular Surgery defines an aneurysm as a permanent localized dilation of an artery with a diameter greater than 50% of the expected size [1]. Pseudoaneurysms result from an arterial leak contained by the surrounding tissues and do not contain an arterial wall. Aneurysms of the iliac arteries are uncommon but dangerous because they often remain asymptomatic until they rupture [2]. Infected true aneurysms and pseudoaneurysms merit special consideration because of the increased propensity to rupture. Imaging may detect these aneurysms/pseudoaneurysms incidentally and detection prior to rupture is critical
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