1.Introduction
External iliac artery injury from a penetrating pelvic trauma although rare can result in a life-threatening hemorrhage and death in up to 60% of cases [1,2] . This type of injury is often associated with simultaneous injuries of surrounding structures but rarely with bladder injury. The formation of an acute ilio-vesical fistula or shunt as an immediate complication of both the external iliac artery and bladder injuries is extremely rare [1,2,3]. Of the few reported cases of external iliac artery and bladder fistuli only 4 are related to pelvic gunshot wounds with only 1 diagnosed at index presentation with an obvious external iliac artery injury and the other 3 diagnosed later as a result of posttraumatic external iliac pseudoaneurysm rupture into the bladder [1,2,4] .