Abstract
Isolated iliac artery pseudoaneurysms are extremely rare and typically asymptomatic. However, symptoms may arise from rupture or compression of adjacent structures, such as the ureter, bowel or deep veins. A 46-year-old male presented with right lower limb swelling and preceding lower abdominal pain of 6 months. Duplex imaging showed iliofemoral deep vein thrombosis. Blood tests showed neutrophil leukocytosis and elevated inflammatory markers. Contrast-enhanced computed tomography demonstrated a large eccentric, irregular right common iliac artery pseudoaneurysm with hydronephrosis, hydroureter, and inferior vena cava compression. Based on the radiological and biochemical investigations, a tentative diagnosis of infected iliac artery pseudoaneurysm was made. The patient was successfully managed with endovascular stent grafting. Deep vein thrombosis is a rare presentation of a infected iliac artery pseudoaneurysm. Early referral and timely intervention are crucial for achieving optimal outcomes.