Blunt traumatic iliac vein injury without pelvic fracture - A case report

Abstract

A 48-year-old man fell asleep while driving a 4-t truck, hit an 11-t truck from behind, and was injured. Contrast-enhanced computed tomography revealed retroperitoneal hematoma and extravasation of contrast medium in the left common iliac vein. No obvious pelvic fracture was observed. The patient showed no hemodynamic deterioration, so conservative management was selected. Computed tomography images obtained 2 days after injury showed that the hematoma around the left common iliac vein had shrunk and no clear vein thrombus was observed. No findings suggestive of deep vein thrombosis or pulmonary embolism were seen after the start of gait training. Iliac vein injury without pelvic fracture due to blunt trauma is particularly rare. This rare injury was attributed to sudden extension of the hip and force in the direction of the long axis of the common iliac vein. Conservative management is the recommended first choice for isolated iliac vein injury with stable hemodynamics.

Keywords: Conservative treatment; Iliac vein; Motor vehicles; Nonpenetrating; Wounds.

Fig. 1

Contrast-enhanced CT shows presacral hematoma and extravasation of contrast medium in the left common iliac vein (arrow). No obvious pelvic fracture or intraabdominal organ damage is observed.

Fig. 2

Contrast-enhanced CT images obtained 2 days after injury show a reduction in hematoma around the left common iliac vein, with no evidence of venous thrombosis or stenosis (arrow).