J Korean Soc Traumatol.  2014 Dec;27(4):215-218. 10.0000/jti.2014.27.4.215.

Common Iliac Artery Injury due to Blunt Abdominal Trauma without a Pelvic Bone Fracture

• Jung PY
• Byun CS
• Oh JH
• Bae KS

• KMID: 2297777
• DOI: http://doi.org/10.0000/jti.2014.27.4.215

Abstract

Blunt abdominal trauma may often cause multiple vascular injuries. However, common iliac artery injuries without associated bony injury are very rarely seen in trauma patients. In the present case, a 77-year-old male patient who had no medical history was admitted via the emergency room with blunt abdominal trauma caused by a forklift. At admission, the patient was in shock and had abdominal distension. On abdomino-pelvic computed tomography (CT), the patient was seen to have hemoperitoneum, right common iliac artery thrombosis and left common iliac artery rupture. During surgery, an additional injury to inferior vena cava was confirmed, and a primary repair of the inferior vena cava was successfully performed. However, the bleeding from the left common iliac artery could not be controlled, even with multiple sutures, so the left common iliac artery was ligated. Through an inguinal skin incision, the right common iliac artery thrombosis was removed with a Forgaty catheter and a femoral-to-femoral bypass graft was successfully performed. After the post-operative 13th day, on a follow-up CT angiography, the femoral-to-femoral bypass graft was seen to have good patency, but a right common iliac artery dissection was diagnosed. Thus, a right common iliac artery stent was inserted. Finally, the patient was discharged without complications.

Keyword

Blunt abdominal trauma; Vascular injury; Common iliac artery

MeSH Terms

Aged
Angiography
Catheters
Emergency Service, Hospital
Follow-Up Studies
Hemoperitoneum
Hemorrhage
Humans
Iliac Artery*
Male
Pelvic Bones*
Rupture
Shock
Skin
Stents
Sutures
Thrombosis
Transplants
Vascular System Injuries
Vena Cava, Inferior