LAUSR

the emergency department. The causes include shock, infection, allergies, immune and urinary tract obstruction, which is the most common reason. Urinary tract obstruction usually occurs in patients with ureteral calculi, prostatic hypertrophy and urinary tumours, and bilateral common iliac artery aneurysm is a rare reason. The symptoms of iliac artery aneurysms are primarily caused by the compression of the adjacent organs or structures, which could cause neurological, urological or gastroenterological symptoms, except in cases of a rupture of the aneurysms. Some of the frequently observed urological symptoms are haematuria and uroschesis, which occur because of the obstruction of the ureter and bladder. Haematuria is relatively rare as it is caused by uretero-iliac aneurysm fistulas, which are an uncommon occurrence; however, hydronephrosis has been reported more often because of the relatively more common occurrence of ureter obstruction. There have been few reported cases of AKI due to the bilateral common iliac artery aneurysms as well. In many cases, AKI is initially misdiagnosed as due to ureteral calculi, prostatic hypertrophy or urinary tumours. The AKI caused by bilateral iliac aneurysms is relatively rare as it is usually asymptomatic in early stages, and clinical manifestations are diverse and complex. Furthermore, although ultrasound can be used for preliminary screening, more advanced techniques, such as CT and magnetic resonance imaging, which have higher sensitivity and specificity for detecting the disease, are not used in routine examination as they are time consuming and expensive; this leads to some difficulties in the diagnosis of this disease. In the present case we could not identify the bilateral common iliac artery aneurysm using ultrasound and we missed it during the treatment. However, we were able to make a certain diagnosis of bilateral common iliac artery aneurysm on CT imaging. The patient underwent open surgery for the aneurysms and was discharged without any complications. Although ultrasound is preferred for such patients, advanced examination techniques, such as CT with clear diagnosis, should be used in cases of unclear diagnosis and inadequate therapeutic effect from initial treatments.