Zhou YX, Ji Y, Chen J, Yang X, Zhou Q, Lv J. Common iliac artery occlusion with small intestinal transection caused by blunt abdominal trauma: A case report and review of the literature. World J Clin Cases 2019; 7(15): 2120-2127 [PMID: 31423446 DOI: 10.12998/wjcc.v7.i15.2120]
Corresponding Author of This Article
Jian Lv, MD, Doctor, Surgeon, Department of General Surgery, People’s Hospital of Jingjiang, Yangzhou University Medical Academy, No. 28, Zhongzhou Road, Jingjiang 214500, Jiangsu Province, China. lvjian11@yahoo.com
Research Domain of This Article
Medicine, Research & Experimental
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
You-Xin Zhou, Yong Ji, Xin Yang, Jian Lv, Department of General Surgery, People’s Hospital of Jingjiang, Yangzhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China
Jing Chen, Imaging Department, People’s Hospital of Jingjiang, Yangzhou University Medical Academy, Jingjiang 214500, Jiangsu Province, China
Qing Zhou, Department of General Surgery, Affiliated Hospital of Jiangsu University, Zhenjiang 212000, Jiangsu Province, China
Author contributions: Zhou YX designed the report; Ji Y and Yang X collected the patient’s clinical data; Zhou Q reviewed the English-language literature; Chen J provided and analyzed the imaging report; Lv J revised the manuscript for intellectual content; Zhou YX was a major contributor in writing of the manuscript; all the authors approved the final version of the article to be published.
Informed consent statement: Consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors have no conflict of interests to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Jian Lv, MD, Doctor, Surgeon, Department of General Surgery, People’s Hospital of Jingjiang, Yangzhou University Medical Academy, No. 28, Zhongzhou Road, Jingjiang 214500, Jiangsu Province, China. lvjian11@yahoo.com
Received: February 26, 2019 Peer-review started: February 27, 2019 First decision: May 31, 2019 Revised: June 22, 2019 Accepted: July 2, 2019 Article in press: July 3, 2019 Published online: August 6, 2019 Processing time: 161 Days and 9.1 Hours
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.
Core tip: Most major abdominal vascular injuries are caused by penetrating injuries. As a subset of arterial blunt trauma, the percentage of iliac arterial injury is small. Common iliac artery occlusion in blunt trauma is especially uncommon. We report such a rare case here. Furthermore, we review the reported cases in the English literature and provide a discussion on the mechanism of injury, clinical presentation and signs, diagnosis, surgical modalities, and outcome.
