An internal iliac artery aneurysm causing sudden buttock ischemia and nerve root compression

Acute buttock ischemia can be a consequence of aneurysmatic disease and has a dramatic presentation. This case report describes an otherwise healthy patient with a simultaneous onset of buttock ischemia combined with sciatic nerve compression caused by a small distal internal iliac artery aneurysm. Coiling of the aneurysm prevented thromboembolism recurrence but was only partially successful in reducing the symptoms of nerve compression. Given the serious consequences, prophylactic treatment independent of aneurysm diameter can be considered.