A Case of Abdominal Aortic Injury Complicated with Bowel Injury Due to Blunt Abdominal Trauma

Abstract

We encountered a case of an abdominal aortic injury due to blunt abdominal trauma. The patient, a 31-year-old man, met with a traffic accident while getting in the passenger seat of a car and was admitted to our hospital. The patient presented hypovolemic shock and abdominal pain. In addition, no femoral pulse was found in the bilateral legs, which appeared pale. An enhanced CT demonstrated free air and hemorrhage around the small bowel and colon, and blunt aortic injury at the level of inferior mesenteric artery with large intimal flap. Aortic lumen below the large intimal flap were reduced in size. We performed an emergency operation based on diagnosis of bowel injury and limb ischemia due to abdominal aortic injury. The large intimal flap of the abdominal aorta, small bowel, and colon were resected by laparotomy. After the operation, symptom of lower limb ischemia was improved. A post-operative enhanced CT revealed the absence of intimal flap, dilatation, and stenosis at the flap resection site of the abdominal aorta. The occurrence of abdominal aortic injury due to blunt abdominal trauma is rare. However, an abdominal aortic injury that is associated with bowel and abdominal solid organ injury can be potentially fatal. Therefore, physicians should carefully consider the possible diagnosis of an abdominal aortic injury due to blunt abdominal trauma. Once the patient is diagnosed with such injury, he should be treated appropriately.