Ruptured aneurysm of the internal iliac artery.

: Our case and others reported in the literature illustrate that isolated aneurysms of the internal iliac artery are uncommon lesions with a highly lethal potential. The classic signs of ruptured abdominal aneurysm--pain, palpable mass, and shock--are usually altered with rupture of these aneurysms because of their deep location in the pelvis. Rectal examination will aid diagnosis. Surgical management of IIA aneurysms 4 cm or larger is indicated at the time of diagnosis, since rupture is usually fatal.