Spontaneous Rupture of the Right External Iliac Vein

Spontaneous rupture of an iliac vein is a very rare condition, with 34 reported cases in the previously published data and only two cases involving the right side. We report the third case of spontaneous rupture of the right external iliac vein. A 62-year-old woman presented with sudden onset of lower abdominal pain and an inability to move the right lower extremity shortly after stretching her right leg backward. A contrast computed tomography demonstrated a massive pelvic retroperitoneal hematoma and a thrombus extending from the inferior vena cava to the right iliac veins. An inferior vena cave filter was inserted using interventional radiology, followed by an exploratory laparotomy. A 1.5-cm laceration in the right external iliac vein was uncovered and repaired. The etiology, clinical features, and treatment of spontaneous iliac vein rupture are discussed.