A Case of Common Iliac Artery Rupture Due to Abdominal Blunt Trauma

Abstract

Blunt injuries rarely cause vascular injury; in particular, the common iliac artery (CIA) rupture is extremely rare. A 58-year-old man was working at a construction site when he took a strong blunt hit to the right quadrant abdomen. He subsequently felt severe pain and came to our hospital. At the time of arrival, the patient was in hypovolemic shock. The right common femoral artery was impalpable, the right lower limb was cold. Contrast-enhanced computed tomography was performed, and the right CIA rupture was detected. To stabilize his hemodynamics, he was transferred to the hybrid operation room, where laparotomy was performed while controlling hemorrhage by inserting an arterial occlusion balloon catheter through the left femoral artery. Surgical findings were rupture of the right CIA and severe calcification at the site of rupture. Moreover, damage to the sigmoid colon and mesocolon were observed. The CIA was ligated the proximal and distal site, followed by a femoro-femoral bypass. In addition, sigmoidectomy was performed. After the surgery, the patients developed rhabdomyolysis due to the ischemia-reperfusion of the right lower limb and temporarily required blood purification therapy. Sixty-six days after the surgery, the patient was discharged from our hospital, walking without any assistance. We saved the patient’s life and limb by using an arterial occlusion balloon to treat the severe hemorrhagic shock associated with the rupture of the CIA.