Case report

Internal iliac artery aneurysms are rare but potentially fatal and can be mistaken with more common medical disorders. Most iliac aneurysms occur in conjunction with aortic aneurysms and their etiology is atherosclerotic and degeneration. This kind of aneurysm includes less than 0.5% of all intra-abdominal aneurysms. Rupture is frequently associated with an exceedingly high mortality rate. Accordingly, these aneurysms are best managed aggressively. They are treated by resection and reconstruction, proximal ligation and over sewing of the distal branches, coil occlusion and endovascular techniques. Currently surgical resection and reconstruction remains the gold standard for definitive management

We present a 72 year old man with an old pelvic fracture history who his chief complaint was bloody discharge from right buttock. His diagnosis in the angiography was right internal iliac artery aneurysm and during a surgery by evacuation his hematoma, the distal and proximal of artery was lighted.

Because of their rarity and their depth in the pelvis internal iliac artery aneurysms are difficult to diagnose and tend to present late. Their symptoms easily get conflicted with other disorders and must be considered in differential diagnosis.