Gunshot Wound to Abdomen Causing Life-Threatening Zone I Retroperitoneal Hematoma from Artery of Adamkiewicz

Author Info

Annie Hess Piroska Kopar

Corresponding Author

Piroska Kopar
Department of Surgery, Washington University School of Medicine, Saint Louis, Missouri, USA

A B S T R A C T

Introduction: Traditionally speaking, all patients with traumatic zone I hematomas should undergo operative exploration because of the high likelihood of injury to the aorta, the inferior vena cava, or one of the major mesenteric vessels. Case Description: We describe the case of a 26-year-old male patient who presented to our level 1 trauma center after sustaining a gunshot wound to his abdomen. Exploration revealed his main source of bleeding to be due to paraspinal arterial injury, specifically the transection of the artery of Adamkiewicz. Hemostasis was obtained via trans-vertebral packing. Discussion: Although traditional teaching dictates emergent operative exploration for patients with penetrating abdominal wounds and hemodynamic compromise, little guidance exists in the literature on the operative management of massive bleeding from paraspinal vessels. It is possible that in select cases, interventional radiologic measures might translate into better functional outcomes for patients with similar injuries.

Article Info

Article Type

Case Report

Publication history

Received: Mon 15, Jun 2020
Accepted: Mon 29, Jun 2020
Published: Sat 04, Jul 2020

Copyright

© 2023 Piroska Kopar. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.GSCR.2020.01.04