eng Science and Education Publishing American Journal of Medical Case Reports 2374-216X 2024-08-08 12 8 114 116 10.12691/ajmcr-12-8-2 AJMCR20241282 article Youichi Yanagawa yyanaga@juntendo.ac.jp 1 Hiroki Nagasawa 1 Hiroaki Taniguchi 1 Atsumi Oishi 2 Munehiro Sugiyama 3 Department of Acute Critical Care Medicine, Shizuoka Hospital, Juntendo University Department of Cardiovascular Surgery, Shizuoka Hospital, Juntendo University Department of Radiology, Shizuoka Hospital, Juntendo University This case report describes a 62-year-old male who presented with left-sided abdominal and lower back pain following a fall, which was followed by a vehicular accident resulting in a helicopter evacuation. Upon arrival, he exhibited signs of shock, including bradycardia and hypotension, with imaging revealing a ruptured left common iliac artery aneurysm (CIAA) and retroperitoneal hematoma. Emergency stent graft placement and embolization were performed, but intraoperative complications led to significant bleeding and the development of abdominal compartment syndrome (ACS). Despite surgical intervention, the patient succumbed to pulseless electrical activity. This case highlights the challenges in managing ruptured isolated CIAAs and the potential for complications such as ACS. Early recognition and prompt intervention are crucial, and consideration of radical or decompressive surgery may be warranted to prevent ACS in similar cases. https://pubs.sciepub.com/ajmcr/12/8/2/ajmcr-12-8-2.pdf left common iliac artery aneurysm shock abdominal compartment syndrome