acute dissection of external iliac artery aneurysm in a postpartum woman: a case report and lessons learned

Arterial aneurysm and dissection in young individuals are extremely rare clinical entities, particularly in the absence of predisposing factors, such as connective tissue disorders, trauma, or known vascular disease. nevertheless, these conditions are often acute and may rapidly lead to life-threatening complications. this article aimed to report a rare case of acute external iliac artery aneurysm dissection in a young pregnant woman.the patient, with no significant medical history or evidence of inherited connective tissue disease, presented to the emergency department with sudden and severe abdominal pain. initial clinical assessment and routine investigations were nonspecific, which contributed to diagnostic difficulty. following further imaging studies, a ruptured external iliac artery aneurysm with dissection was diagnosed. immediate multidisciplinary management was required due to the high risk of maternal and fetal mortality associated with vascular rupture during pregnancy. the physiological, hormonal, and hemodynamic changes of pregnancy—such as increased blood volume, cardiac output, and vascular wall stress—may contribute to the development and progression of arterial aneurysms and dissections, even in young patients without known risk factors.this case highlights the importance of considering rare but catastrophic vascular causes in the differential diagnosis of acute abdominal pain during pregnancy. although arterial dissection is uncommon in younger populations, clinicians should maintain a high index of suspicion for vascular pathology when pregnant women present with unexplained acute pain in any region of the body. early recognition, timely imaging, and rapid intervention are essential to improve clinical outcomes and prevent fatal complications. this case emphasizes the need for increased awareness of pregnancy-associated vascular emergencies and contributes to the limited literature on iliac artery aneurysm dissection in young pregnant women.