Korean J Urol.  2010 Aug;51(8):583-585. 10.4111/kju.2010.51.8.583.

Hematuria Secondary to an Internal Iliac Artery Aneurysm

• Makatsori
• Stavropoulos NE

• KMID: 1997029
• DOI: http://doi.org/10.4111/kju.2010.51.8.583

Abstract

We report a case of macroscopic hematuria secondary to an aneurysm of the internal iliac artery. An 84-year-old male presented to our department with a 12-hour history of painless gross hematuria. Cystoscopy showed decreased expansion suggesting compression from outside the bladder. At the point of compression, increased vascularization was noted in the bladder mucosa without evidence of active bleeding. No trace of blood was identified coming from the ureteric orifices, the bladder neck, or the prostate. There was no evidence of intra-vesicular masses or other inflammatory changes. The abdominal computed tomography scan revealed left-sided hydronephrosis and an abdominal aortic aneurysm involving the aortic bifurcation and both internal iliac arteries. There was no evidence of rupture. An aneurysm of the internal iliac artery is a rare cause of macroscopic hematuria that can be fatal. Awareness of this as a possible cause of hematuria may assist in immediate diagnosis and appropriate treatment.

Keyword

Aneurysm; Hematuria

MeSH Terms

Aged, 80 and over
Aneurysm
Aortic Aneurysm, Abdominal
Cystoscopy
Hematuria
Hemorrhage
Humans
Hydronephrosis
Iliac Artery
Male
Mucous Membrane
Neck
Prostate
Rupture
Ureter
Urinary Bladder

Figure

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  FIG. 1 Contrast-enhanced abdominal CT scan showing an abdominal aortic aneurysm and internal iliac artery aneurysm (sagittal view).

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  FIG. 2 Contrast-enhanced abdominal CT scan showing an abdominal aortic aneurysm and internal iliac artery aneurysm (coronal view).

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  FIG. 3 Contrast-enhanced pelvic CT scan showing the aneurysm of the left internal iliac artery protruding into the urinary bladder (transverse view).

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  FIG. 4 Contrast-enhanced abdominal CT scan showing external compression of the bladder by the abdominal aortic and internal iliac artery aneurysm (coronal view).

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