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Complete occlusion after blunt injury to the abdominal aorta
Colin A L Meghoo1, Ernest A Gonzalez, Alan H Tyroch
1Department of Surgery, William Beaumont Army Medical Center, Texas Tech University Health Sciences Center, El Paso, Texas 79920-5001, USA. colin.meghoo@cen.amedd.army.mil
Background:
Injury to the abdominal aorta after blunt trauma is uncommon. When this injury results in complete vessel occlusion, the presentation is dramatic. Timely intervention is essential.
Methods:
After a case report, we examined all reported cases of complete occlusion after blunt injury to the abdominal aorta and reviewed the cause, presentation, and management of this injury.
Results:
Complete vessel occlusion arises from intimal injury. The most frequent mechanism is compression from a seat belt or steering wheel during a motor vehicle crash. Patients present with absent femoral and distal pulses in association with lower extremity neuropathy. Intervention commonly involves bypass grafting of the abdominal aorta.
Conclusion:
Complete occlusion after blunt trauma to the abdominal aorta is rare. Neurologic deficits most commonly arise from peripheral nerve ischemia. Reperfusion within 6 hours confers a greater chance of limb salvage and neurologic recovery.