Giant Right Common Iliac Artery Aneurysm with Right Common Iliac Vein Fistula, Masquerading as Deep-Vein Thrombosis

Abstract

Abstract Iliac artery aneurysm is rarely known to rupture into iliac vein, leading to features of aneurysm and in particular, right ventricular volume overload, and pulmonary artery hypertension, due to the extracardiac left to right shunt. Herein, we report the case of a 67-year-old gentleman who presented with massively swollen right lower limb, leading to pain and inability to walk without support for 1 month. He was diagnosed to have and treatment for deep vein thrombosis with Vitamin K antagonist for 2 years. Contrast computed tomography angiogram of the abdomen revealed giant right iliac artery aneurysm above its bifurcation with iliac vein fistula. He underwent open repair of aneurysm and transaneurysmal suture closure of the iliac fistula. However, for transient renal dysfunction and reexploration for pelvic hematoma, his recovery, including normalized right lower limb, was smooth.