Traumatic left femoral vein injury

Case contribution: Dr Radhiana Hassan


  • A 36 years old man
  • No known medical illness
  • Bus driver, head on collision with lorry
  • Had transient loss of consciousness
  • Complaint of pain at lower abdomen and left lower limb
  • BP=112/80mmHg, PR=106 bpm
  • Soft tissue injury with skin loss noted at left femoral region
  • Ultrasound abdomen shows no evidence of intra-abdominal injury and no free fluid
  • CT brain and CT cervical shows no intracranial or cervical spine injury
  • Hb drop from 10.3 to 5.8 to 4.8 g/dL
CT scan abdomen pelvis in axial plane soft tissue window post contrast


  • No solid organ injury is seen.
  • No hemoperitoneum. No free air in the peritoneum
  • Soft tissue injury with skin loss noted at left lower abdomen, perineum and inguinal region (yellow arrows)
  • Minimal hematoma anterior to left femoral artery and vein (white arrow)
  • The outline of left femoral vein is deformed (red arrow) with suspicious contrast extravasation
  • Delayed images do not demonstrate obvious blood pooling
  • No fracture of visualized bones.

Intra-operative finding:

  • Left femoral vein laceration
  • Left femoral artery is normal
  • Detail of operation procedure not available

Diagnosis: Femoral vein injury due to trauma


  • A study reported isolated venous injury in 13% of vascular trauma injury to the lower limbs.
  • In most cases it is due to penetrating injury rather than blunt trauma.
  • Otherwise there is limited data on isolated venous injury post trauma.
  • In most cases the injury was found in patients who underwent exploration for the indication of suspected arterial injury.
Author: radhianahassan