Unexpected sudden death caused by iliac artery aneurysm rupture: two forensic cases study

Isolated iliac artery aneurysm is a rare but potentially fatal vascular condition, characterised by an extremely low prevalence and a tendency to remain clinically silent until rupture occurs. We report two forensic cases of sudden death resulting from ruptured iliac artery aneurysms diagnosed at post-mortem examination. In both cases, cardiovascular risk factors such as smoking and alcohol abuse were present; however, there was no prior clinical history or specific symptoms indicative of an aneurysm. Autopsy findings revealed extensive retroperitoneal haemorrhage as the immediate cause of death. Histopathological analysis confirmed the presence of atherosclerotic changes and inflammatory alterations in the arterial wall. These cases underscore the critical role of forensic autopsy in identifying vascular causes of sudden death. They also highlight the necessity for increased clinical vigilance regarding iliac aneurysms, even in asymptomatic individuals, particularly those with established vascular risk factors. Early identification could facilitate preventive strategies aimed at reducing mortality, not only for affected individuals but potentially for at-risk family members as well.