• Shuliang Zhang, Hongfeng Sheng, Bin Xu, and Yangjun Lao.
• Department of Orthopaedics, Tongde Hospital of Zhejiang Province, Hangzhou, China.
• Medicine (Baltimore). 2021 Feb 12; 100 (6): e24710e24710.

RationalePelvic fractures associated with acute external iliac artery thrombosis is less common, it is easily ignored in clinical practice, and it can result in limb amputation and hemipelvectomy due to prolonged limb ischemia. We present 2 patients with acute external iliac artery thrombosis following pelvic fractures.Patient ConcernsCase 1 is a 49-year-old male with occlusion of the right external iliac artery and pelvic fractures. Case 2 is a 52-year-old male with left external iliac artery occlusion and bilateral internal iliac artery rupture following pelvic fractures.DiagnosesCase 1 was diagnosed with computed tomography angiography. Case 2 was diagnosed with ultrasound examination and computed tomography angiography.InterventionsCase 1 was performed an open incision to remove thrombus of the right external iliac artery, the right iliac-femoral artery artificial bypass was adopted to restore the blood flow. Case 2 underwent segmental resection of the damaged artery and artificial vascular implantation of left external iliac artery, and angiographic embolization of bilateral internal iliac artery. However, a left hip disarticulation was performed due to osteofascial compartment syndrome at last.OutcomesCase 1 was cured and discharged smoothly. Case 2 survived but left with a disability after disarticulation.LessonsAcute external iliac artery thrombosis after pelvic fractures is rare and limb-threatening, life-threatening. It is very important to detect and treat this potential complication timely when a patient with a pelvic fracture.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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