Gunshot wound to big blue

Harfouche, Melike; Feliciano, David V.

doi:10.1136/tsaco-2019-000368

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…In such cases, emergent ligation may be necessary [ 5 ]. It is important to note that in hypovolaemic and hypotensive patients, complete occlusion of the infrarenal IVC will further worsen the hypotension due to decreased venous return [ 6 ]. In the case of complete hepatic vascular isolation, patients commonly suffer worsening shock or cardiac arrest as the venous return to the heart decreases [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Traumatic Injury and Complete Ligation of the Inferior Vena Cava: A Case Report

Alhalyan,

Nidal,

Almoosawi

et al. 2023

Cureus

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This case report describes an occurrence of a traumatic injury to the inferior vena cava (IVC) secondary to penetrating trauma. A 37-year-old male patient presented to the emergency department (ED) after sustaining a stab wound to the mid back. The patient was transferred directly to the operating theatre (OT) and underwent an emergency exploratory laparotomy. A through-and-through IVC injury at the level of the entry to the liver bed was identified. Surgical repair was attempted but failed, followed by eventual IVC ligation. The patient was shifted to the intensive care unit postoperatively for damage control resuscitation while the abdomen was temporarily closed. He later required a re-look procedure for definitive treatment, after which he could mobilize without assistance and return home. This case highlights the different surgical approaches to an IVC injury and examines postoperative complications and their management.

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Section: Discussionmentioning

confidence: 99%

Traumatic Injury and Complete Ligation of the Inferior Vena Cava: A Case Report

Alhalyan,

Nidal,

Almoosawi

et al. 2023

Cureus

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“…Other recent reports also document that the mortality of an injury to the IVC is in the range of 30 to 70%, depending on the anatomic level, where retrohepatic injuries are known to have high mortality rate, with more distal injuries being associated with better survivorship. [7][8][9][10][11][12] Due to the physiologic state of these patients at presentation, frequent concomitant injuries, and known high mortality, surgical management often includes damage control, commonly including IVC ligation. 7,10,13 In the review by Sullivan et al 14 in 2010, this was demonstrated to be an acceptable method for rapid control of hemorrhage, and long-term sequelae were uncommon among survivors.…”

Section: Introductionmentioning

confidence: 99%

Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment

Stonko

Azar

Betzold

et al. 2021

The American Surgeon™

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Introduction Injuries to the inferior vena cava (IVC), while uncommon, have a high mortality despite modern advances. The goal of this study is to describe the diagnosis and management in the largest available prospective data set of vascular injuries across anatomic levels of IVC injury. Methods The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry was queried from November 2013 to January 2019. Demographics, diagnostic modalities, injury patterns, and management strategies were recorded and analyzed. Comparisons between anatomic levels were made using non-parametric Wilcoxon rank-sum statistics. Results 140 patients from 19 institutions were identified; median age was 30 years old (IQR 23-41), 75% were male, and 62% had penetrating mechanism. The suprarenal IVC group was associated with blunt mechanism (53% vs 32%, P = .02), had lower admission systolic blood pressure, pH, Glasgow Coma Scale (GCS), and higher ISS and thorax and abdomen AIS than the infrarenal injury group. Injuries were managed with open repair (70%) and ligation (30% overall; infrarenal 37% vs suprarenal 13%, P = .01). Endovascular therapy was used in 2% of cases. Overall mortality was 42% (infrarenal 33% vs suprarenal 66%, P<.001). Among survivors, there was no difference in first 24-hour PRBC transfusion requirement, or hospital or ICU length of stay. Conclusions Current PROOVIT registry data demonstrate continued use of ligation extending to the suprarenal IVC, limited adoption of endovascular management, and no dramatic increase in overall survival compared to previously published studies. Survival is likely related to IVC injury location and total injury burden.

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Gunshot wound to big blue

Cited by 2 publications

References 8 publications

Traumatic Injury and Complete Ligation of the Inferior Vena Cava: A Case Report

Traumatic Injury and Complete Ligation of the Inferior Vena Cava: A Case Report

Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment

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