Korean J Pain.  2014 Oct;27(4):360-364. 10.3344/kjp.2014.27.4.360.

Large Sized Common Iliac Artery Aneurysm with Thrombus Developing a Diagnostic Confusion in a Patient with Sciatica

• Jeon IC
• Kim SW
• Jung YJ

• KMID: 1802503
• DOI: http://doi.org/10.3344/kjp.2014.27.4.360

Abstract

The causes of sciatica are variable and include musculoskeletal, dermatologic, infectious, neoplastic, and vascular disorders. In many cases, the symptom is usually caused by degenerative disease in the spine with the compression or irritation of spinal nerve. On the other hands, there are also several announced extra-spinal causes including aneurysm, diabetes, and radiation for sciatica in a low rate. Among the extra-spinal cases, aneurysms arising from iliac vessels are sometimes developing a diagnostic confusion with the spinal causes, and delayed diagnosis can lead to poor prognosis. It is very important to pay attention weather the aneurysmal cause is involved in the symptom of sciatica.

Keyword

iliac aneurysm; lumbar spine; sciatica

MeSH Terms

Aneurysm*
Delayed Diagnosis
Hand
Humans
Iliac Aneurysm
Iliac Artery*
Prognosis
Sciatica*
Spinal Nerves
Spine
Thrombosis*
Weather

Figure

• 

  Fig. 1 Non-contrast magnetic resonance imaging (MRI) of the lumbar spine. Axial T2-weighted images (A) show disc bulging and left foraminal and subarticular stenosis of L4-5. There is a large sized aneurysm with thrombus (white arrow) arising from left common iliac artery of L5 body level with irritating the surrounding lumbosacral plexus (red arrow) on axial (B) and sagittal (C) images. Thrombus inside of the aneurysm shows a tendency to grow compare to previous MRI (D) at the first-visit hospital.

• 

  Fig. 2 Enhanced whole abdominal computed tomography (CT). CT shows huge hematoma presenting as a leakage of dye (red arrow) on retroperitoneal space and a calcified large sized fusiform aneurysm containing thrombus and arising from left common iliac artery. There are true (white arrow) lumen filled with dye and false lumen (black arrow) occupied with thrombus inside of the vessel.

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