The elusive isolated hypogastric artery aneurysm: Novel presentations

William C. Krupski, Arie Bass, Garth D. Rosenberg, Ralph B. Dilley, Ronald J. Stoney

Research output: Contribution to journalArticlepeer-review

Abstract

Isolated aneurysms of the internal iliac artery are rare. Their anatomic location makes them true pelvic aneurysms and they may grow to a large size undetected. Their late recognition may be prompted by rupture or symptoms related to compression of neurologic, gastrointestinal, genitourinary, or venous structures. We have encountered three isolated hypogastric artery aneurysms with unique presentations. In one patient with bilateral isolated hypogastric artery aneurysms, one ruptured into the bladder, and at a later time the other caused ureteral obstruction. Another patient had obturator neuropathy as a result of this aneurysm. In the patient with large bilateral aneurysms, one was detected by rectal examination, and the other was found by palpation of the abdomen. The second patient with a smaller aneurysm required examination of the pelvis by CT scanning to establish the diagnosis. Awareness of the existence of these lesions is required to identify such patients who describe symptoms uncommonly associated with abdominal aneurysms. Operative management consisted of exclusion of the aneurysm and partial or complete aneurysmorrhaphy with preservation of iliac arterial flow to maintain extremity perfusion. Recovery was complete in each instance. A review of published cases is presented.

Original languageEnglish
Pages (from-to)557-562
Number of pages6
JournalJournal of Vascular Surgery
Volume10
Issue number5
DOIs
StatePublished - Nov 1989
Externally publishedYes

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