Abstract
Lacerations of the inferior vena cava are associated with a high mortality and may be difficult to repair. The majority of injuries are due to penetrating trauma. Rapid transportation to definitive surgical care with effective resuscitation may improve mortality. Surgical management includes adequate treatment of hypovolemic shock due to blood loss. Placement of intravenous infusion sites below the level of the diaphragm may be effective. Operative control of the inferior vena cava can be accomplished by directed digital compression followed by a proximal and distal control. Injuries of the inferior vena cava above the level of the renal veins are associated with an increased mortality. Retrohepatic and subdiaphragmatic injuries are highly lethal. This article discusses appropriate surgical approaches for repair of the inferior vena cava above and below the diaphragm.
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Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aprahamian C., Thompson B. M., Towne J. B., Darin J. C. The effect of a paramedic system on mortality of major open intra-abdominal vascular trauma. J Trauma. 1983 Aug;23(8):687–690. doi: 10.1097/00005373-198308000-00001. [DOI] [PubMed] [Google Scholar]
- Burch J. M., Feliciano D. V., Mattox K. L., Edelman M. Injuries of the inferior vena cava. Am J Surg. 1988 Dec;156(6):548–552. doi: 10.1016/s0002-9610(88)80550-6. [DOI] [PubMed] [Google Scholar]
- Burch J. M., Feliciano D. V., Mattox K. L. The atriocaval shunt. Facts and fiction. Ann Surg. 1988 May;207(5):555–568. doi: 10.1097/00000658-198805000-00010. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Millikan J. S., Moore E. E. Outcome of resuscitative thoracotomy and descending aortic occlusion performed in the operating room. J Trauma. 1984 May;24(5):387–392. doi: 10.1097/00005373-198405000-00003. [DOI] [PubMed] [Google Scholar]
- Pilcher D. B., Harman P. K., Moore E. E., Jr Retrohepatic vena cava balloon shunt introduced via the sapheno-femoral junction. J Trauma. 1977 Nov;17(11):837–841. doi: 10.1097/00005373-197711000-00003. [DOI] [PubMed] [Google Scholar]
- Posner M. C., Moore E. E., Greenholz S. K., Burdick D. C., Clark D. C. Natural history of untreated inferior vena cava injury and assessment of venous access. J Trauma. 1986 Aug;26(8):698–701. doi: 10.1097/00005373-198608000-00003. [DOI] [PubMed] [Google Scholar]
- Stewart M. T., Stone H. H. Injuries of the inferior vena cava. Am Surg. 1986 Jan;52(1):9–13. [PubMed] [Google Scholar]
