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This is a report of a case of false aneurysm of the external iliac artery associated with pre-existing bone irradiation necrosis and postoperative infection of a total hip replacement arthroplasty in a 77-year-old woman. Vascular injury, when it does occur, requires prompt recognition, proper exposure and adequate treatment while techniques of primary suture should be used for closure of most defects, extensive ligation, resection and grafting procedures may be required in certain instances to control hemorrhage and maintain necessary circulation. The most important factors are an awareness of the likelihood of vascular pathology prior to surgery and the importance of angiographic examination in any patient in whom suspicion of such defects exists.
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