Takahashi Hiroyuki, Shoko Tomohisa, Okamoto Hiroyuki, Shimizu Takahumi, Oshiro Akiko, Onishi Shinsuke, Morishita Yuka, Nara Satosi
Department of Emergency and Critical Care Medicine, Tokyo Women's Medical University Medical Center East, 2-1-10 Nishiogu, Arakawa-ku, Tokyo 116-8567, Japan.
Emergency and Critical Care Medical Center, Teine Keijinkai Hospital, 1-jo 12-chome, Maeda, Teine-ku, Sapporo 006-8555, Japan.
Trauma Case Rep. 2021 Feb 10;32:100412. doi: 10.1016/j.tcr.2021.100412. eCollection 2021 Apr.
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.
一名48岁男子驾驶一辆4吨重的卡车时睡着,从后方撞上一辆11吨重的卡车并受伤。增强计算机断层扫描显示腹膜后血肿和左髂总静脉造影剂外渗。未观察到明显的骨盆骨折。患者无血流动力学恶化,因此选择保守治疗。受伤2天后获得的计算机断层扫描图像显示,左髂总静脉周围的血肿已缩小,未观察到明确的静脉血栓。开始步态训练后未发现提示深静脉血栓形成或肺栓塞的迹象。钝性创伤导致无骨盆骨折的髂静脉损伤极为罕见。这种罕见损伤归因于髋关节突然伸展以及沿髂总静脉长轴方向的力。对于血流动力学稳定的孤立性髂静脉损伤,保守治疗是推荐的首选方法。