The patient was referred to a vascular surgeon following detection of a right common iliac artery aneurysm on an abdominal ultrasound at a radiology practice. A scan of the abdominal and pelvic arteries was requested for confirmation. 

It is important to assess the internal iliac arteries for evidence of aneurysmal dilatation as these vessels supply the rectum, internal iliac artery aneurysms are difficult to detect by CTA and are difficult to treat if they rupture. They are often obscured by gas but marked turbulent flow may raise suspicion. Here, peak systolic velocity within the proximal right internal iliac artery is raised indicating a 50-75% stenosis.