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Journal of Trauma and Injury 2014;27(4):215-218.
Common Iliac Artery Injury due to Blunt Abdominal Trauma without a Pelvic Bone Fracture
Pil Young Jung, Chun Sung Byun, Joong Hwan Oh, Keum Seok Bae
1Department of Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea. bksgs@yonsei.ac.kr
2Department of Thoracic and Cardiovascular Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
복부 둔상 환자에서 골반 골절을 동반하지 않고 발생한 총장골동맥 손상 증례
정필영, 변천성1, 오중환1, 배금석
연세대학교 원주의과대학 원주세브란스기독병원 외과학교실, 1흉부외과학교실
Received: 9 November 2014   • Revised: 25 November 2014   • Accepted: 2 December 2014
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.
Key Words: Blunt abdominal trauma; Vascular injury; Common iliac artery


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