You-Xin Zhou1, Yong Ji1, Jing Chen2, Xin Yang1, Qing Zhou3, Jian Lv4. 1. Department of General Surgery, People's Hospital of Jingjiang, Yangzhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China. 2. Imaging Department, People's Hospital of Jingjiang, Yangzhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China. 3. Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu Province, China. 4. Department of General Surgery, People's Hospital of Jingjiang, Yangzhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China. lvjian11@yahoo.com.
Abstract
BACKGROUND: Most major abdominal vascular injuries are caused by penetrating injuries. A common iliac artery occlusion caused by blunt force trauma is rare, and very few cases have been reported. Because of this low incidence, atypical symptoms, and frequent association with other severe injuries, the proper diagnosis tends to be missed or delayed. The gold standard for diagnosis is angiography, and treatment remains a challenge. CASE SUMMARY: We report here the unusual case of a common iliac artery occlusion caused by blunt abdominal compressive trauma, with transection of the small intestine. At presentation, the patient (a 56-year-old man) complained of pain and numbness in the left lower extremity and severe pain in the whole abdomen. Physical examination showed total abdominal tenderness with evidence of peritoneal irritation. The left lower limb was pulseless and cold. Abdominal computed tomography examination revealed digestive tract perforation, and abdominal computed tomography angiography showed left common iliac artery occlusion. The patient was treated successfully by anastomosis of the intestine, percutaneous transluminal angioplasty, and stenting. The patient was followed for more than 11 mo after the operation and showed a good recovery. CONCLUSION: Patients with abdominal trauma should be suspected of having major vascular injury. Individualized treatment strategies are needed for this condition.
BACKGROUND: Most major abdominal vascular injuries are caused by penetrating injuries. A common iliac artery occlusion caused by blunt force trauma is rare, and very few cases have been reported. Because of this low incidence, atypical symptoms, and frequent association with other severe injuries, the proper diagnosis tends to be missed or delayed. The gold standard for diagnosis is angiography, and treatment remains a challenge. CASE SUMMARY: We report here the unusual case of a common iliac artery occlusion caused by blunt abdominal compressive trauma, with transection of the small intestine. At presentation, the patient (a 56-year-old man) complained of pain and numbness in the left lower extremity and severe pain in the whole abdomen. Physical examination showed total abdominal tenderness with evidence of peritoneal irritation. The left lower limb was pulseless and cold. Abdominal computed tomography examination revealed digestive tract perforation, and abdominal computed tomography angiography showed left common iliac artery occlusion. The patient was treated successfully by anastomosis of the intestine, percutaneous transluminal angioplasty, and stenting. The patient was followed for more than 11 mo after the operation and showed a good recovery. CONCLUSION:Patients with abdominal trauma should be suspected of having major vascular injury. Individualized treatment strategies are needed for this condition.
Entities:
Keywords:
Anastomosis of the intestine; Blunt abdominal trauma; Case report; Common iliac artery occlusion; Percutaneous transluminal angioplasty; Transection of the small intestine
Authors: Konstantinos O Papazoglou; Christos D Karkos; Thomas E Kalogirou; Ioakeim T Giagtzidis Journal: Ann Vasc Surg Date: 2014-11-22 Impact factor: 1.466