Inferior vena cava injuries--a continuing challenge.
The mortality from abdominal vena cava trauma remains in excess of 33% despite advances in prehospital and intraoperative care. During the 7-year period ending December 1981, 58 patients with vena cava injuries were treated at our institution. Thirty-nine (67%) were due to gunshot wounds, nine to stab injuries, and ten to blunt trauma. Overall mortality was 38%. Predictors of poor survival were: 1) presence of shock upon hospital arrival; 2) multiple abdominal vascular injuries; and 3) injuries in the retrohepatic segment. Only two (17%) of 12 patients survived retrohepatic wounds despite various shunting techniques. Of the remaining 12 deaths, 11 (92%) had associated major vascular trauma that included four portal system, three aortic, and three iliac artery injuries. This contrasts to a 96% survival rate for the 28 patients without associated abdominal vascular injuries. Our experience underscores the importance of rapid resuscitation, early operation, and searching for associated vascular injuries before a time-consuming repair of the vena cava is undertaken. Improving the survival of patients with blunt retrohepatic cava and hepatic vein trauma remains a dilemma.[1]References
- Inferior vena cava injuries--a continuing challenge. Millikan, J.S., Moore, E.E., Cogbill, T.H., Kashuk, J.L. The Journal of trauma. (1983) [Pubmed]
Annotations and hyperlinks in this abstract are from individual authors of WikiGenes or automatically generated by the WikiGenes Data Mining Engine. The abstract is from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.About WikiGenesOpen Access LicencePrivacy PolicyTerms of Useapsburg
