Presentation
Long-standing type II diabetes mellitus and end-stage renal disease. Kidney grafted three months ago. Nausea, vomit, anuria, leg swelling and pain located near the kidney graft for the last seven days.
Patient Data
Double focal dilatation of the external iliac artery on a contrast-enhanced study.
Double J catheter is seen reaching transplant kidney pelvis.
Mild free ascites at the pelvis. Subcutaneous edema is noted as well.
Color Doppler ultrasound exam revealed two "yin-yang sign" within the external iliac artery, compatible with pseudoaneurysms.
Case Discussion
Iliac artery aneurysms are rare, they represent less than 2% of abdominal aneurysms. External iliac arterial involvement is very rare. Pseudoaneurysms are abnormal dilatations of arteries bounded only by the tunica adventitia. They are commonly associated with trauma. Yin-yang sign is an ultrasound feature described in pseudoaneurysms. A contrast-enhanced CT study might help confirm the diagnosis.