¹Hassan Mashbari, ²Abdullah Hasan Alhojaili, ³Saleh abdulaziz almansour, ⁴Ghadir Hamzah Badr, ⁵Amal Sayfuldeen Qari, ⁶Mohammed Omar Abdullah Miftah

¹Assistant Professor in Surgery, Department of Surgery, Jazan University, Saudi Arabia, Email: hnmashbari@jazanu.edu.sa

²Trauma and Acute Care Fellow, Department of General Surgery, King Fahad Hospital In Madina, Email: Alhojailiabdullah@gmail.com

³Assistant consultant, Department of General Surgery, King Fahad Hospital in Madina, Email: Saleh-almansour@outlook.sa

⁴General surgery resident, Department of General Surgery, King Fahad Hospital in Madina, Email: Hamzah.Ghadeer19@gmail.com

⁵General Surgery Resident, Dr. Soliman Fakeeh Hospital, Jeddah, MSc Clinical Anatomy Student, KSA, Email: Amalqari123@gmail.com

⁶Mohammed Omar Abdullah Miftah, Trauma and acute care fellow, Department of General Surgery, King Khalid University Hospital in Riyadh, KSA, Email: Miftah_1982@yahoo.com

Corresponding Author: Hassan Mashbari, Assistant Professor in Surgery, Department of Surgery, Jazan University, Saudi Arabia, Email: hnmashbari@jazanu.edu.sa

Citation: Hassan Mashbari, Abdullah Hasan Alhojaili, Saleh abdulaziz almansour, Ghadir Hamzah Badr, Amal Sayfuldeen Qari, Mohammed Omar Abdullah Miftah (2025) Penetrating Abdominal Trauma in Pregnancy Complicated by Aortic, IVC, and Uterine Injuries: A Rare Case Report. World J Case Rep Clin Imag. 2026 January; 5(1)1-7.

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Abstract:

Background: Trauma is the leading non-obstetric cause of maternal mortality and is associated with high fetal morbidity and mortality. Penetrating abdominal trauma during pregnancy is uncommon, but when complicated by major vascular and uterine injuries, it carries extremely poor outcomes. Case Presentation: A 34-year-old pregnant woman sustained multiple stab wounds to the abdomen and back. On arrival, she was conscious but hemodynamically unstable. E-FAST demonstrated intra-abdominal free fluid, and emergent laparotomy revealed a Zone 1inframesocolic hematoma. Both the infrarenal aorta and inferior vena cava (IVC) were injured. After obtaining supraceliac control, the vascular injuries were repaired with 4-0 Prolene sutures. Two full-thickness uterine perforations were identified, and hysteretomy was performed, resulting in delivery of a non-viable fetus. Postoperative CT showed additional thoracic injuries, including pneumothoraces and pulmonary contusions. The patient required left chest tube insertion but was extubated by postoperative day 2, transferred to the ward by day 4, and discharged home on day 8. At two-week follow-up, she remained clinically stable with a healed surgical wound. Conclusion: This case demonstrates the complexity of managing penetrating abdominal trauma in pregnancy, particularly when complicated by combined great vessel and uterine injuries. Maternal stabilization must be prioritized, as maternal survival remains the strongest determinant of fetal outcome. Despite poor fetal prognosis, timely diagnosis, aggressive resuscitation, prompt surgical repair, and multidisciplinary collaboration can result in successful maternal survival.  

Keywords: Pregnancy; Penetrating abdominal trauma; Aortic injury; Inferior vena cava injury; Uterine injury; Case report; Maternal survival; Fetal outcome