[Aneurysms of the iliac artery in fibromuscular dysplasia as differential diagnostic consideration in acute lower abdominal pain].

A 48 year old woman was admitted to our department with sudden onset of pain in the left lower abdominal quadrant and the initial diagnosis of diverticulitis or left sided adnexitis was made. On physical examination she was found to have pain and localized peritonism in the left lower abdominal quadrant. Ischemic signs in the same sided lower limb could not be observed. Further diagnostics (abdominal ultrasonography, transvaginal ultrasonography, angiography and computed tomography) showed a covered perforated aneurysm in the left common or internal iliac artery as the reason for the abdominal pain. Coincidental focal aneurysms were seen in the middle segment of both renal arteries and also in the right common iliac artery. The patient was treated with an aorto-iliac-bypass (Impra-prosthetic graft). Histological examination showed features of fibromuscular dysplasia. We are reporting this case due to the unusual localisation, the atypical symptoms and the difficult diagnostics.