Common iliac artery occlusion with small intestinal transection caused by blunt abdominal trauma: A case report and review of the literature

Table 1 Demographic and clinical profile of the cases of compression injury of the lower abdomen in the literature

Age (sex)	Cause of injury	Location	Symptom and sign	Auxiliary examination	Associated injuries
44 (M)	Car crash	Right	Cold right lower leg; absent right femoral, popliteal, and pedal pulses; absent left popliteal and pedal pulses	Angiography	Subarachnoid and intraventricular hemorrhage and diffuse axonal injury; subcapsular hematoma of the liver, splenic laceration, comminuted fracture of the left iliac wing, and widening of the left sacroiliac joint; contusion of the mid-abdomen
27 (M)	Crushed between a fork-lift truck and a concrete platform	Bilateral	Cold and loss of motor function for both feet, with the right foot being worse; no femoral or pedal pulse	Doppler scanning; arteriography	Pelvic and right acetabular fracture; retroperitoneal bladder rupture; abdominal wall disruption
74 (F)	Seatbelt injury	Bilateral (aortic bifurcation disruption)	Pulseless and cold	No	Contusion of chest wall and left lung; complete disruption of the lower abdominal muscles; intestinal transection with mesenteric disruption
26 (M)	Abdominal and lumbar spine compression in a metal press	Left	Cold and pale; reduction of power and sensory loss; no pulsation of the femoral artery	ACTA	Contusion of the abdominal wall; retroperitoneal hematoma in the left psoas muscle
9 (M)	Seatbelt-related injury	Right (aortic dissection)	A cold right lower leg	MRA	Intestinal perforation; fractures of the lumbar spine
51 (M)	Abdomen compression by a tractor against a house wall	Right (aortic dissection)	Cold and pale; no palpable artery pulses	ACTA	Traumatic perforations of the ileum and transversal colon
35 (M)	Seatbelt injury	Right	Absent right femoral, popliteal, and posterior tibial pulses	No	Multiple scalp and face lacerations; bowel transections of descending colon and one segment of the small bowel
56 (M)	Lower abdomen compression between two forklifts	Left	Pain; cold and numb; pulsation of the left dorsal pedal artery disappeared	ACTA	Transection of small intestine

ACTA: Abdominal computed tomography angiography; MRA: Magnetic resonance angiography.

Table 2 Treatment details and prognosis of the 8 cases

Operative delay time	Procedure	Fasciotomy	Result
< 4 h	Endovascular stenting	No	Died due to complications of brain injury
Shortly after admission	Endovascular stenting	Right	Right leg paralysis persisted secondary to severe lumbar plexus nerve injury
Shortly after admission	Aortoiliac bypass with spiraled saphenous vein graft	Bilateral	Died due to severe acute respiratory distress syndrome and associated pulmonary sepsis
Shortly after admission	Endovascular stenting	No	Good
After 4 d	Endovascular stenting	Right	Well-perfused right lower limb with normal pulses but paraplegic
Shortly after admission	Use of anterior longitudinal ligament and great saphenous vein graft	No	Good
Approximately 3 h	Segmental excision and internal iliac artery patch angioplasty	No	Good
After 4 d	Endovascular stenting	No	Good