Abstract
A 21-year-old male who had been crushed in a car due to a traffic accident was transferred to the emergency department. His vital signs were stable but the contrast-enhanced computed-tomography (CT) scan showed a retroperitoneal hemorrhage and the extravasation of contrast dye at the level of the 4th lumbar artery. A follow-up CT scan on the following day indicated a 4th lumbar artery pseudoaneurysm. Open abdominal surgery was performed because the patient was relatively young and interventional radiology (IVR) would have been difficult due to the small margin between the pseudoaneurysm and the abdominal aorta. The avulsion injury of 4th lumbar artery was directly repaired with pledgets. Cases of lumbar artery injury induced by iatrogenic factors, such as a renal biopsy and lumbar disc surgery, have been previously reported. There are also some reports of a lumbar artery pseudoaneurysm occurring secondary to a lumbar fracture and pelvic fracture in trauma patients. However this is the first case report of a pseudoaneurysm due to a traumatic avulsion injury of the lumbar artery. A careful approach is therefore the key to effectively treating a traumatic avulsion injury of the lumbar artery because of the difficulties in applying IVR.
