Effective hemostasis by preperitoneal pelvic packing for common iliac vein injury without pelvic fracture in severe blunt trauma: a case report

Background: A common iliac vein injury in the absence of pelvic fractures due to blunt trauma is rare, with no treatment strategy established.

Case presentation: A 48-year-old man, who was injured in a dumbwaiter accident, presented to the hospital with hemorrhagic shock. Computed tomography (CT) revealed active bleeding from the intercostal and hepatic arteries as well as the left common iliac vein. No pelvic fracture was noted. Preperitoneal pelvic packing was performed for the left common iliac vein injury as a damage control surgery. After the operation, endovascular embolization was performed to address the arterial bleeding. The patient became hemodynamically stable, and follow-up CT showed no signs of bleeding. The packing gauze was removed 3 days after the admission. The patient was discharged without complications.

Conclusion: Preperitoneal pelvic packing provided temporary hemostasis in a hemodynamically unstable patient with common iliac vein injury but with no pelvic fractures.