J.Jpn. Surg. Soc.. 88(5): 633-636, 1987

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Case report

ACASE OF ACUTE OCCLUSION IN THE LEFT COMMON DUE TO BLUNT ABDOMINAL TRAUMA

A 56-year-old man was involved in an automobile accident and had abdominal blunt injury with the steering wheel. He developed slight abdominal distension and pulselessness, cold sensation and peripheral cyanosis of the left lower extremity which suggested acute arterial occlusion. DSA revealed complete obstruction of the common iliac artery near its origin and the leakage of contrast medium at peripheral branch of the SMA. Four and a half hours after injury, surgical exploration was carried out. Laparotomy showed the laceration of the mesentery with accumulation of massive fresh and clotted blood in the abdominal cavity. Obstructed portion of the left common iliac artery was resected and arterial reconstructon was performed with prothetic graft (8mm Gore-Tex for end to end left common-left external iliac bypass, 6mm Gore-Tex for side to end right common-left hypogastric bypass). A resected specimen demonstrated completely distrupted intima, resulting in the obstruction of the lumen associated with distal fresh thrombosis. The postoperative course was uneventful with successful patency of both grafts.

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