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Internal iliac aneurysms (IIAs) are a rare group of intra-abdominal aneurysms that, if not diagnosed and treated promptly, can lead to significant morbidity and mortality. We present a case of an elderly Chinese male who presented acutely with abdominal pain due to a leaking left IIA. Prompt diagnosis and expedient treatment with a hybrid approach, i.e. with endovascular balloon occlusion followed by surgical excision of the IIA, led to an excellent outcome. Case presentation is followed by a brief discussion of the current literature on the management of this elusive condition.

Internal iliac aneurysm: an unusual cause of acute abdomen pain – case presentation and brief review