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Mirza A., Bunting D.
Department of Surgery, North Devon District Hospital, Raleigh Park, Barnstaple, UK
Internal iliac artery aneurysm is a rare entity and with rupture, heralds an extremely poor outcome. Mortality is reduced by early diagnosis and management. An 82-year-old male presented with acute onset of supra-pubic discomfort and urinary retention. Attempted urethral catheterisation proved unsuccessful. Following admission overnight, the patient was taken to theatre for cystoscopic insertion of a urethral catheter, whereupon a large extra-vesical mass was noted. At laparotomy a diagnosis of a ruptured right internal iliac artery was made. Exclusion of the aneurysm was achieved by simple ligation. The patient died following admission into the Intensive Care Unit. Internal iliac artery aneurysm is a rare entity associated with a dismal prognosis following rupture. Awareness of unusual presentations will aid in making a prompt diagnosis and allow expeditious treatment.