September 1977

Idiopathic Rupture of the Iliac Vein

Arch Surg. 1977;112(9):1148. doi:10.1001/archsurg.1977.01370090130037

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To the Editor.—It was with great interest that we noted the report "Idiopathic Rupture of the Iliac Vein," by Brown et al (Arch Surg 112:95, 1977). In September of 1976, we encountered a strikingly similar case. A 70-year-old woman was admitted to the Toronto Western Hospital with an eight-hour history of severe low back pain of sudden onset. Initial examination revealed a systolic blood pressure of 40 mm Hg and a mass in her abdomen. A tentative diagnosis of a leaking abdominal aortic aneurysm was made and she was taken to surgery. The findings at laparotomy included a huge retroperitoneal hematoma originating from a 3-cm tear in the left common iliac vein. Despite extensive search, no other source for the bleeding was found and no other pathology was demonstrated. The tear was repaired and the procedure was terminated. The patient's postoperative course was marked by a left iliofemoral venous

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