Ruptured Giant Abdominal Aortic Aneurysm with Bilateral Giant Common Iliac Artery Aneurysms: A Case Report

Giant abdominal aortic aneurysms (AAAs), often defined by a maximum transverse diameter exceeding 13 cm, are rarely reported. We report a case of multiple giant aortoiliac aneurysms comprising a ruptured giant AAA and bilateral giant common iliac artery aneurysms (CIAAs). A 59-year-old male was transferred to our emergency department with a ruptured AAA. Computed tomography angiography (CTA) showed a ruptured giant infrarenal AAA measuring 16.9×9.7 cm and bilateral CIAAs measuring 9.6×9.7 cm and 9.0×8.7 cm. The patient underwent successful open surgical repair with an aortoiliac bifurcated graft. An intraoperative left ureteral injury was immediately repaired by end-to-end anastomosis over a double-J stent. Postoperative CTA demonstrated successful graft reconstruction without leakage. The patient recovered without further major complications and was discharged on postoperative day 23. This case highlights the technical challenges of treating multiple giant aortoiliac aneurysms and demonstrates that emergency open repair can achieve a favorable outcome.