Lumbar artery pseudoaneurysm following blunt trauma: A case report and literature review

Lumbar artery pseudoaneurysms following blunt trauma are very rare. We report a case of polytrauma patient having lumbar spine injury and pelvic fracture presenting with hemodynamic instability. The patient did not improve after aggressive resuscitation. There was no evidence of intraabdominal solid organ or visceral injury. We suspected injury to pelvic vessels as a source of bleeding. Computed tomography (CT) angiography was done. A small size (6 × 5 mm) lobulated hyperdense structure is seen in the territory of a left 4th lumbar branch of aorta suggestive of a pseudoaneurysm. Whenever there is a patient of blunt abdominal trauma with pelvic or spine injury and source of bleeding cannot be established, lumbar vessels as a source of bleeding should be kept in mind. CT angiography must be done for diagnosis and patient may subsequently need angioembolization of these vessels.