Iliac vein rupture (IVR) is a rare but critical clinical condition often presenting with nonspecific symptoms such as acute abdominal pain and hemorrhagic shock, leading to significant diagnostic challenges. This case report illustrates the complexity of IVR through the clinical course of an elderly female patient with multiple comorbidities, who was ultimately diagnosed with spontaneous IVR following surgical intervention. The case emphasizes the necessity of a multidisciplinary approach involving surgical, vascular, and critical care teams to facilitate timely diagnosis and management. The patient's presentation, characterized by severe pain and hypotension, was initially suggestive of retroperitoneal hemorrhage, yet definitive diagnosis was elusive until surgical exploration was conducted, highlighting the limitations of imaging modalities in certain instances. Furthermore, this case underscores the importance of considering individual risk factors, such as previous pelvic surgeries and underlying venous pathology, in formulating patient-specific care strategies. The successful management of this case not only contributes valuable insights to the existing literature but also advocates for heightened awareness and education among healthcare professionals regarding IVR. Although the rarity of IVR poses challenges to generalizability, it underscores the need for standardized diagnostic protocols and innovative management strategies tailored to high-risk populations. In conclusion, this case serves as a reminder of the critical role of prompt recognition and intervention in improving patient outcomes for those affected by iliac vein rupture.
Dong et al. (Fri,) studied this question.