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A Rare Cause of Popliteal Artery and Vein Transection: A Case Report and Literature Review
Shamon Gumbs1, Maria Guevarra-Kissel1, Gonzalo Ausqui1
1General Surgery, Columbia University College of Physicians and Surgeons, Harlem Hospital Center, New York, USA.
Abstract:
We present a rare occurrence of popliteal vascular injury due to blunt trauma. The patient had an isolated blunt lower extremity trauma. The patient subsequently experienced moderate tenderness and non-expanding hematoma at the popliteal fossa, reduced range of motion at the knee, and diminished distal pulses. X-rays showed a patella dislocation and tibial plateau non-displaced fracture but no knee dislocation. CT angiography showed an abrupt non-opacification of the distal portion of the popliteal artery with an overlying large hematoma. Surgical exploration was performed which revealed a concomitant transection of the popliteal artery and vein with a 5 cm defect. It was repaired with an interposition graft, and a fasciotomy was also performed. Literature has noted that although the overall incidence of popliteal injuries is low, when present due to blunt trauma there is increased morbidity. A high index of suspicion is recommended for vascular injuries in all patients with blunt trauma to the lower extremities. Minimizing time to diagnosis and intervention for limb salvage and improved outcomes.
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