SPONTANEOUS LEFT ILIAC VEIN RUPTURE

Abstract

Spontaneous retroperitoneal hematoma associated with iliac vein rupture is a rare and life-threatening emergency. We report a case of spontaneous left iliac vein rupture in a healthy 49-year-old woman, with no relevant medical past history or history of trauma. On the day she was admitted on the emergency room she had a syncope episode and was hypotensive and tachycardic on arrival. She suffered from back pain, which started 5 days prior to admission. Workup with contrast-enhanced computed tomography revealed a large retroperitoneal hematoma without evidence of arterial bleeding. Due to hemodynamic instability an emergency exploratory laparotomy was performed. Intra-operatively, retroperitoneal exploration, revealed a large hematoma caused by a left primitive iliac vein rupture. The vein was repaired primarily with control of the bleeding. She was taken to the Intensive Care Unit for postoperative follow-up where she subsided to cardiopulmonary arrest on the same day. This case provides insight to an uncommon cause of retroperitoneal hematoma and haemorrhagic shock that should be taken into account on the emergency room.