Background: Rupture of isolated iliac artery dissections is a life-threatening event and has not been associated with cystic medial degeneration (CMD) Erdheim-Gsell.
Methods: A young man presented to our emergency unit in a critical hemodynamic condition. Computed tomography scan feigned the rupture of an internal iliac artery.
Results: Surprisingly, we found a ruptured dissection of the common iliac artery during open surgery. Reconstruction was done by Dacron graft interposition between common and internal iliac artery and external iliac artery implantation into the graft. Histology revealed CMD.
Conclusions: Spontaneous iliac artery dissection and rupture can be caused by CMD and requires immediate surgical intervention.
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