External iliac artery occlusion by bicycle handle injury

Blunt injury in a youth to the external iliac artery with secondary thrombosis, associated clinically with a seemingly minor blunt injury to the right lower quadrant of the abdomen, is presented. Symptoms were delayed, but eventually became dramatic. The methods of diagnosis and evaluation are discussed and the selection of the operative procedure is outlined. The potential of significant vascular injury should be suspected and followed closely in all blunt injuries in the proximity of major vascular conduits. Early and aggressive treatment in the young is mandatory to prevent not only the usual complications of limb ischemia, but the discrepant limb lengths seen in the growing youth deprived of normal circulation to an extremity.