A 78 year-old female presents with right-sided, sharp abdominal pain.  A CT scan is obtained. 

Answer: Ruptured iliac aneurysm

• Please note the free fluid in the right lower quadrant in the CT scan
• Patients may present with acute abdominal pain and clinical signs of shock. 
• Iliac aneurysm is frequently misdiagnosed as urologic, bowel, or GYN disorders