A case of spontaneous rupture of nonaneurysmal left iliac artery due to penetrating atherosclerotic ulcer

Abstract

We report on a patient with spontaneous rupture of a nonaneurysmal left common iliac artery in whom hemorrhagic shock developed. A 64-year-old woman presented with hemodynamic collapse accompanied by sudden abdominal pain. She was transported to the emergency department. Angiography showed a penetrating atherosclerotic ulcer in the left common iliac artery. Emergency surgery was performed with graft replacement (14 x 7 mm woven Dacron graft). Severe calcification was observed in the left common iliac artery, and an ulcer of the iliac artery was confirmed as the source of hemorrhage. The postoperative course was uneventful, and the patient was discharged on postoperative day 14. We conclude that rupture may occur in patients with severe atherosclerotic change, even in the absence of aneurysm.