Bleeding Prolapsed Hemorrhoids as a Presentation of Ruptured Internal Iliac Artery Aneurysm: Report of a Case

Abstract

Internal iliac artery aneurysms (IIAAs) are rare and their concealed location in the pelvis presents a diagnostic challenge. We report a case of a 79-year-old man who presented 12 years after an abdominal aortic aneurysm repair, with signs of prolapse, bleeding, hemorrhoids, and a deep vein thrombosis. His condition rapidly deteriorated, with the development of acute renal failure and obvious perianal and perineal ecchymoses, within a few days. Abdominal ultrasound and computed tomography showed a ruptured IIAA. His renal function returned to normal after surgical decompression of the aneurysm.

Ruptured Hypogastric Artery Aneurysms

“…At laparotomy, rupture into the sigmoid colon subserosa was discovered. 11 Other gastrointestinal (GI) symptoms included lower GI bleeding, anemia, constipation, and tenesmus. [12][13][14][15][16][17] Presentations involving the urinary system have also been reported and include urinary retention, urgency, nocturia, incontinence, hematuria, and renal failure.…”

“…19,20 For aneurysms that have ruptured into the colon, successful repair has been achieved by aneurysm exclusion in addition to segmental colonic resection and diversion or primary repair (Table 1). [11][12][13][14]16,17…”