Mukendi Alain Mwamba, Mathye Charles Eustachia
Division of Urology, Department of Surgery, Helen Joseph Hospital University of the Witwatersrand Johannesburg South Africa.
Clin Case Rep. 2023 May 4;11(5):e07331. doi: 10.1002/ccr3.7331. eCollection 2023 May.
This is the first reported case of a pelvic gunshot wound with a bladder injury masking a coinciding left external iliac artery injury. A high index of suspicion for an acute and traumatic ilio-vesical fistula should be raised in the presence of the following triad: bright red hematuria, bladder distension from clot retention, hemodynamic instability after bladder decompression "Mukendi's triad."
Iliac artery injury from gunshot wounds is very rare and a lethal injury associated with high mortality rate. Concurrent ballistic external iliac artery and bladder injuries resulting in an acute ilio-vesical shunt or fistula and discovered at the time of presentation are extremely rare.In this report, we present an unprecedented case of multiple pelvic gunshot wounds presented with a distended injured bladder full of clots concealing a left external iliac injury by tamponade effect.
