Acute Common Iliac Artery Occlusion Secondary to Blunt Abdominal Trauma From Motor Vehicle Accident

Abstract

Blunt abdominal trauma infrequently leads to vascular injuries, and common iliac artery (CIA) injuries after motor vehicle accidents due to seat belt injury are very rare. Its posterior anatomic location and the pelvic bones usually protect the CIA. We describe a case of a young female presenting with acute blunt trauma to the abdomen after being a restrained driver in a motor vehicle accident and was found to have acute left CIA occlusion. The purpose of this case is to stress the importance of maintaining a high index of suspicion for vascular injuries in blunt abdominal trauma; we recommend early imaging diagnosis and timely treatment to mitigate its complications.

Keywords: abdominal trauma; acute common iliac artery occlusion; blunt trauma; complication; motor vehicle accident.

Figure 1. Acute occlusion of the left common iliac artery

(A, B, I, J, and K) CT demonstrating occluded left common iliac artery, sigmoid colon injury with active extravasation, hemoperitoneum, and small bowel edema. (C, D, E) CT demonstrating unstable chance fracture status post-posterior percutaneous fusion with vertebroplasty. (F, G, H) MRI of the lumbar spine demonstrating unstable chance fracture with small epidural hematoma. (L) Ankle-brachial index of the patient demonstrating severely decreased ratio of 0.39 in the left posterior tibial artery and 0 in the dorsalis pedis artery, indicating severe arterial insufficiency compared to normal 1.1 on the right side.