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Click 30-year-old male with vascular type EDS and fatal ruptured right common iliac artery dissection. FINDINGS: Axial CECT of pelvis in the arterial phase performed when the patient initially presented to the emergency department demonstrates large right retroperitoneal hematoma and a large hematoma anterior to the right external iliac artery. A posterior dissection flap divides the proximal right external iliac artery into a larger anterior false lumen and a smaller compressed posterior true lumen. The proximal right internal iliac artery is seen posterior to the dissected right external iliac artery. Note the loss of the normal interface between the vessel wall and the mesenteric fat by the hemorrhagic fat stranding. TECHNIQUE: Siemens Sensation 64 slice multi-detector CT, 300mAs, 120KVP, 3mm axial slice thickness, 120ml of omnipaque 360 intravenous contrast agent.

Click 30-year-old male with vascular type EDS and fatal ruptured right common iliac artery dissection. These images were taken after open resection of the aneurysm and ligation of the CIA at its origin. FINDINGS: Post surgical follow up axial CECT of the pelvis in the arterial phase demonstrates a large left retroperitoneal hematoma anterior to the left common iliac artery bifurcation and the left psoas muscle. A left psoas muscle hematoma is seen as asymmetrically and hyper-densely enlarged in comparison to the right psoas muscle. There is a small amount of extravascular leakage of the intravenous contrast anterior to the right psoas muscle in the right lower quadrant, which is suggestive of either vascular repair leakage or new vascular rupture after surgical excision and ligation of the ruptured right common iliac artery dissection. Note left internal iliac artery dissection and absent opacification of the right external and internal iliac arteries at the same level. TECHNIQUE: Siemens Sensation 64 slice multi-detector CT, 120KVP, 300mAs, 3mm axial slice thickness, 120ml of omnipaque 360 intravenous contrast agent.

Click 30-year-old male with vascular type EDS and fatal ruptured right common iliac artery dissection. These images were taken after open resection of the aneurysm and ligation of the CIA at its origin. FINDINGS: Coronal reformation of the postoperative axial enhanced CT of the pelvis in the arterial phase demonstrates large left retroperitoneal hematoma causing significant mass effect and upward displacement of the left kidney and a small lateral side wall left internal iliac artery dissection with a larger lateral false lumen and a smaller compressed medial true lumen. Note absent opacification of the surgically removed right common iliac artery and also note the left psoas intra-muscular hematoma. TECHNIQUE: Coronal 4mm slice thickness reconstruction of the abdomen and pelvis, the original acquisition was done using a Siemens Sensation 64 slice multi-detector CT, 180mAs, 120KVP, 5mm coronal slice thickness, 120ml of omnipaque 360 intravenous contrast agent.