title: Endovascular management of ruptured common iliac mycotic aneurysm in an HIV-positive patient.
abstract: Isolated iliac artery aneurysms are a rare entity. The majority of cases are asymptomatic and often escape detection. Mortality rates after sudden rupture and emergent surgery for iliac artery aneurysm are very high. We report a case of a 56-year-old man who presented with right hip pain masquerading as septic arthritis or psoas abscess. CT showed ruptured right common iliac artery aneurysm with extensive active extravasation into psoas with a retroperitoneal haematoma. Aneurysm was repaired using an endovascular technique. Postoperative recovery was eventful with the patient experiencing severe back pain radiating down the leg accompanied with fever. CT showed persistent, right iliopsoas haematoma and pelvic haematoma with secondary hydronephrosis. Viral screen for hepatitis B, C and HIV returned positive. The patient was started on intravenous meropenem. Fever and pain settled. Repeated CT scan showed decrease in retroperitoneal pelvic haematoma.
authors.affiliation: Department of Vascular Surgery, University Hospital Limerick, Limerick, Ireland.
authors.forename: Aamir
authors.initials: A
authors.lastname: Aziz
authors.forename: Busi
authors.initials: B
authors.lastname: Mooka
authors.forename: Mary
authors.initials: M
authors.lastname: Clarke Moloney
authors.forename: Eamon
authors.initials: E
authors.lastname: Kavanagh
mesh_terms: D000785:Aneurysm, Infected / Q000150:complications / Q000601:surgery*; D017542:Aneurysm, Ruptured / Q000150:complications / Q000601:surgery*; D057510:Endovascular Procedures; D006679:HIV Seropositivity / Q000150:complications; D006801:Humans; D007083:Iliac Artery; D008297:Male; D008875:Middle Aged
references.citation: J Vasc Surg. 1989 Oct;10(4):381-4
references.pmid: 2795762
references.citation: Asian Cardiovasc Thorac Ann. 2007 Aug;15(4):280-4
references.pmid: 17664198
references.citation: Eur J Vasc Endovasc Surg. 2001 Jul;22(1):77-85
references.pmid: 11461108
references.citation: Cardiovasc Intervent Radiol. 2005 Jan-Feb;28(1):83-6
references.pmid: 15602635
references.citation: J Vasc Surg. 1998 Jul;28(1):1-11; discussion 11-3
references.pmid: 9685125
references.citation: J Vasc Surg. 2007 Oct;46(4):648-54
references.pmid: 17764880
references.citation: Arch Surg. 1978 Nov;113(11):1289-93
references.pmid: 708250
references.citation: J Vasc Surg. 1988 Aug;8(2):165-71
references.pmid: 3294450
references.citation: Urology. 1980 Jul;16(1):101-3
references.pmid: 7395001
references.citation: J Cardiovasc Surg (Torino). 1992 May-Jun;33(3):331-6
references.pmid: 1601918
references.citation: J Vasc Surg. 2008 Jun;47(6):1203-1210; discussion 1210-1
references.pmid: 18514838
references.citation: Eur J Vasc Surg. 1991 Aug;5(4):375-81
references.pmid: 1915902
references.citation: J Bone Joint Surg Br. 2010 Jan;92(1):153-4
references.pmid: 20044695
references.citation: J Cardiovasc Surg (Torino). 1992 Nov-Dec;33(6):679-83
references.pmid: 1287004
references.citation: J Vasc Surg. 2008 Apr;47(4):708-713
references.pmid: 18381130
references.citation: Surgery. 1983 May;93(5):688-93
references.pmid: 6845175
references.citation: Urology. 1985 Jul;26(1):62-3
references.pmid: 4012982
references.citation: J Vasc Surg. 1995 Oct;22(4):409-15; discussion 415-6
references.pmid: 7563401
references.citation: J Vasc Surg. 2001 Jan;33(1):106-13
references.pmid: 11137930
references.citation: J Bone Joint Surg Br. 2006 Nov;88(11):1524-6
references.pmid: 17075103