RUPTURED SOLITARY ILIAC ARTERY ANEURYSMS - A SILENT KILLER - REPORT OF 4 CASES AND REVIEW OF THE LITERATURE

Between 1982 and 1991, 38 cases of ruptured solitary iliac artery aneu rysm (SIAA) were reported in the English literature. Iliac artery aneu rysms are frequently found in conjunction with abdominal aortic aneury sm (AAA); however SIAA is a rare entity. Review of the literature and 4 new cases revealed a diversity of clinical presentation that may be partially explained by various mechanisms of SIAA rupture. Different f rom rupture of the AAA, symptoms of ruptured or leaking SIAA may be ob scure and even present as a chronic disease. Emergent operative manage ment is mandatory and requires endoaneurysmorrhaphy with interposition graft for the common and external iliac aneurysms or ligation of inte rnal iliac aneurysms. The reported mortality of up to 75% reflects the delay in diagnosis, lack of operative experience with this particular entity, and frequent associated complications.