RESUMO
Pseudoaneurysm of the iliac arteries are rarely reported in the literature. Failure to identify the pathology may delay the necessary treatment, and potentially lead to high mortality. We report a case of ruptured mycotic iliac artery aneurysm in a 46-year-old man with newly diagnosed diabetes mellitus. Initial CT appearance mimicked psoas abscess. However, further CT showed features more suggestive of a psoas haematoma with heterogeneous hyperdensities within the lesion. A ruptured mycotic iliac artery aneurysm was diagnosed. Patient was urgently referred to the vascular team for endovascular stenting. Blood-stained purulent material was noted in the left psoas muscle intra-operatively. It was drained and sent for culture, which later yielded Salmonella Enteritidis sensitive to cefotaxime. We present this case to highlight the importance of reviewing any pre-contrast intramuscular hyperdensities which may suggest acute blood content, and raise suspicion of adjacent vascular pathologies.