Internal Iliac Artery Aneurysm in a Patient with Proximal Occlusion at Its Origin

We present the case of an 87-year-old man with a ruptured right internal iliac artery aneurysm with hemoperitoneum. The right internal iliac artery aneurysm appeared to fill from the retrograde profunda femoris artery in the setting of a previously repaired abdominal aortic aneurysm with aorta-bi-iliac bypass with ligation of the bilateral internal iliac arteries. Abdominal computed tomography revealed an aneurysm of the right internal iliac artery measuring 8.9 cm, with filling through the collateral vessels. Open repair was performed, leading to complete exclusion of the aneurysm with no perioperative complications.