Isolated aneurysmal degeneration and dissection of the iliac artery, without involving the aorta, are uncommon, with an overall incidence in the general population being as low as approximately 0.03%. Solitary iliac artery aneurysm represents approximately 0.4 to 1.9% of all cases of aneurysmal disease; with involvement of external iliac artery being the least common and extremely rare and present in only 10% of these cases. Risk factors for external iliac dissection resulting from an aneurysm, are similar to that of abdominal aorta aneurysm and include male gender, white race, advancing age, history of smoking, hypertension and known atherosclerotic disease.
We present a case of a 70 year old Caucasian male, with a past medical history of well controlled hypertension, dyslipidemia and remote history of smoking, who underwent a contrast enhanced CT Abdomen and pelvis to evaluate a renal cyst. However, was found to have short segment right external iliac artery dissection without distal propagation. He reported no symptoms - denied intermittent leg pain on exertion, lumbosacral pain, lower extremity edema, weakness or numbness/tingling in his legs. Also, denied urinary or bowel complains including urinary retention, pain during defecation and constipation. He reported a 28 pack year history of smoking and had quit smoking 50 years ago. Vital signs were recorded as: blood pressure 114/68 mmHg, pulse rate 66 bpm, respiratory rate 16 breaths/min and body temperature 96.6F. On physical examination, abdomen was soft, non tender, non distended and bowel sounds were present in all four quadrants. No guarding or rigidity was noted. Peripheral pulses were well palpable and equal. Laboratory data including CBC and CMP were within normal limits. ESR and CRP were 12 and
In conclusion, this is a rare case of isolated asymptomatic external iliac artery dissection, diagnosed as an incidental finding. The treatment of this condition is unclear because of its rare occurrence. Cases complicated with rupture/ symptomatic patients should be treated surgery or endovascular repair. Asymptomatic patients with smaller size of
| Identifer | oai:union.ndltd.org:ETSU/oai:dc.etsu.edu:asrf-1401 |
| Date | 12 April 2019 |
| Creators | Kad, Amiksha, Kohli, Varun, MD, Bains, Nimrat, MD, Mahajan, Akhilesh, MD, Khalid, Muhammad, Das, Debalina |
| Publisher | Digital Commons @ East Tennessee State University |
| Source Sets | East Tennessee State University |
| Detected Language | English |
| Type | text |
| Source | Appalachian Student Research Forum |
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