Introduction:

Iliac vein injuries are associated with high morbidity and mortality, with a feared complication of hemorrhage. We discuss management and the thought process behind mitigating such emergencies.

Case Presentation:

An 81-year-old Caucasian male was seen intraoperatively by Vascular Surgery for hemorrhage from an injured left external iliac vein (LEIV) in the setting of left radical nephrectomy and ureterectomy.

Conclusion:

Despite initial temporizing efforts by Urology, Vascular Surgical intervention proved necessary in hemostasis, venous reconstruction and thus, establishing continuity of lower extremity venous drainage.

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