Ligation as Definitive Management of Injury to the Superior Mesenteric Vein

Donahue, Terrence K.; Strauch, Gerald O.

doi:10.1097/00005373-198804000-00023

Cited by 39 publications

(26 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Donahue et al [4] actually showed an improvement in patient survival in those who underwent ligation (85%) versus venorrhaphy (64%). This is especially impressive considering that most ''patients in the group undergoing ligation were more physiologically compromised than those who had a primary repair'' [4]. This also confirms the importance of identifying the need for damage control measures early on in a physiologically stressed patient.…”

Section: Discussionmentioning

confidence: 96%

“…Injuries specific to the SMV are even less common with just over 100 reported in the literature [3,4]. Unlike trauma to the superior mesenteric artery (SMA) [5], only 5-10% of all SMV injuries occur as a result of blunt trauma [3].…”

Section: Discussionmentioning

confidence: 99%

“…Unlike trauma to the superior mesenteric artery (SMA) [5], only 5-10% of all SMV injuries occur as a result of blunt trauma [3]. Furthermore, multiple associated injuries are typical, and act as important contributors to patient outcome [3][4][5]. These most commonly include trauma to the small bowel, pancreas, SMA, inferior vena cava (IVC), duodenum, stomach, colon, liver, abdominal aorta and kidney, in order of decreasing frequency [6].…”

Section: Discussionmentioning

confidence: 99%

“…Overall, the mortality rate associated with one injured intra-abdominal vessel approximates 45% [3]. While patient numbers range from 2 to 45 in published series, survival associated with SMV injuries varies from 43 to 100% [4][5][6][7][8][9][10][11][12][13][14][15]. The range in survival for any series with greater than 10 SMV injuries however, is 43-81% [5, 6, 8-11, 13, 15].…”

Section: Discussionmentioning

confidence: 99%

“…Although expert opinion ranges from venorrhaphy in nearly all cases [6], to simple ligation for most injures [4], there appears to be very little difference in mortality among patients [5]. Donahue et al [4] actually showed an improvement in patient survival in those who underwent ligation (85%) versus venorrhaphy (64%). This is especially impressive considering that most ''patients in the group undergoing ligation were more physiologically compromised than those who had a primary repair'' [4].…”

Section: Discussionmentioning

confidence: 99%

See 4 more Smart Citations

Traumatic Injury of the Superior Mesenteric Vein: Ligate, Repair or Shunt?

Ball

Kirkpatrick

Smith³

et al. 2007

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

We report a case of SMV injury in a critically ill patient. The patient was a 19-year-old woman involved in a motor vehicle collision. Her injuries included grade II splenic and renal lacerations, devascularized and lacerated right and transverse colon, a transected transverse mesocolon, a massive shear injury of her abdominal wall, and two partial SMV transections. At initial damage control laparotomy, the SMV was ligated, the devascularized bowel resected and a temporary abdominal closure applied. At re-operation, a mesocaval shunt using saphenous vein was employed. The shunt failed and the patient required a saphenous vein jump graft. Although visceral vascular injuries are rare, ligation of the SMV in a damage control situation is acceptable. This case study is the first to discuss appropriate treatment when interruption to a patient's collateral visceral venous drainage limits the surgeon's ability to ligate. In these situations, bypass shunts may be successful.

show abstract

Section: Discussionmentioning

confidence: 96%