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A Man with Severe, Left Lower Quadrant Abdominal Pain.
Ta-Jen Wen1, Yu-Te Su1, Hung-Yen Ke2
1Tri-Service General Hospital, National Defense Medical Center, Department of Emergency Medicine, Taipei, Taiwan.
Clinical Practice and Cases in Emergency Medicine
|August 18, 2023
Summary
Rupture of the common iliac artery, a rare condition, can be rapidly diagnosed using point-of-care ultrasonography (POCUS) in emergency settings. This imaging technique aids in quick patient disposition for critical hypotension.
Area of Science:
- Vascular Surgery
- Emergency Medicine
- Diagnostic Imaging
Background:
- Common iliac artery rupture is an uncommon vascular emergency.
- Clinical presentations are often nonspecific, delaying diagnosis and treatment.
- Prompt diagnosis is crucial for patient survival.
Purpose of the Study:
- To highlight the utility of point-of-care ultrasonography (POCUS) in diagnosing common iliac artery rupture.
- To emphasize the importance of POCUS in emergency settings for critical hypotension.
Main Methods:
- Case presentation of an 84-year-old male with sudden left lower quadrant pain and critical hypotension.
- Immediate performance of point-of-care ultrasonography (POCUS) in the emergency department.
- Ultrasonographic findings included pulsatile flow extravasation and para-aortic fluid collection.
Main Results:
- POCUS revealed extravasation of pulsatile flow from the left common iliac artery into the left psoas muscle.
- A hypoechoic para-aortic fluid collection was identified.
- The findings were consistent with common iliac artery rupture.
Conclusions:
- Common iliac artery rupture is a rare condition with nonspecific clinical signs.
- Point-of-care ultrasonography (POCUS) is a valuable tool for rapid diagnosis in emergency situations.
- Combining clinical assessment with POCUS findings enables quick patient disposition.
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