Multiple injuries of iliac veins are uncommon and frequently fatal. An unusual case in which there were injuries of the four iliac veins by gunshot is described. Prompt control of hemorrhage is required. Because our patient was in unstable condition, ligation of the four iliac veins was performed and the abdomen was packed. After a complicated course, the patient was discharged after 40 days in good condition. Although venous repair is often recommended, ligation in extensive injuries may be necessary, and is usually well tolerated in young, previously healthy individuals like our patient.
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