Simultaneous Acute Appendicitis and Isolated Common Iliac Artery Aneurysm: A Case Report.

This case report presents the rare simultaneous occurrence of acute appendicitis and a large right common iliac artery aneurysm in a 69-year-old male with a history of diabetes and hypertension. The patient presented with right lower quadrant abdominal pain and a pulsatile mass. Diagnostic imaging via computed tomography angiography revealed a 95 × 75 mm fusiform aneurysm and radiologic signs of acute appendicitis. Given the high risk of aneurysmal rupture and the presence of symptomatic appendicitis, a combined open surgical approach was undertaken. This involved aneurysm repair with a Dacron graft and standard appendectomy. Histopathology confirmed acute suppurative appendicitis and atherosclerotic changes in the aneurysm wall. The patient recovered well postoperatively, with imaging confirming graft patency and no residual inflammation. This case highlights the importance of comprehensive imaging and a multidisciplinary surgical strategy when managing concurrent intra-abdominal vascular and gastrointestinal emergencies.