Abdominal Compartment Syndrome Complicating Emergency Endovascular Aneurysm Repair for Ruptured Common Iliac Artery Aneurysm

This case report describes a 62-year-old male who presented with left-sided abdominal and lower back pain following a fall, which was followed by a vehicular accident resulting in a helicopter evacuation. Upon arrival, he exhibited signs of shock, including bradycardia and hypotension, with imaging revealing a ruptured left common iliac artery aneurysm (CIAA) and retroperitoneal hematoma. Emergency stent graft placement and embolization were performed, but intraoperative complications led to significant bleeding and the development of abdominal compartment syndrome (ACS). Despite surgical intervention, the patient succumbed to pulseless electrical activity. This case highlights the challenges in managing ruptured isolated CIAAs and the potential for complications such as ACS. Early recognition and prompt intervention are crucial, and consideration of radical or decompressive surgery may be warranted to prevent ACS in similar cases.