Iliac Arterial Injury Associated with Pelvic Fracture in Blunt Abdominal Trauma: A Case Report

Abstract

Exsanguination accounts for up to 65% mortality of traumatic patients with known pelvic fracture. Majority of the haemorrhage is caused by bleeding from venous plexuses and fractured cancellous bone. Arterial bleeding only accounts about 15% of the haemorrhage and primarily from branches of iliac arteries. Injury to iliac arteries with bleeding or thrombosis is uncommon and difficult to diagnose. It is a devastating condition associated with significant consequences including limb loss or even mortality without prompt diagnosis and management. The diagnosis can only be made with high index of suspicion and repeated careful examination. In this report, we describe the management of a case of pelvic fracture with multiple concomitant injures including common iliac artery occlusion that was successfully managed with a femorofemoral bypass. (Hong Kong j.emerg.med. 2014;21:329-333)