Traumatic Suprahepatic Inferior Vena Cava Injury: Surgical Management

Prabhu, Ashwin; Karim, Rafeek A.; Thazhkuni, Ismail E.; Rajendran, Sunil; Thamaran, Ranjish A.; Vellachamy, Kannan A.; Sridharan, Varadaraj; Vettath, Murali P.

doi:10.1097/imi.0b013e318158ccde

Cited by 2 publications

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“…The suprahepatic region of the IVC is challenging for surgical intervention, as it requires dividing the falciform ligament, cross clamping, mobilizing the damaged IVC segment and extending the abdominal incision into a full sternotomy. Intervention is associated with high perioperative mortality and morbidity rates and long-term complications, including IVC stenosis and thrombosis [8–10]. Nearly, all case reports describing the repair of these lesions involve the use of cardio-pulmonary bypass and grafting the damaged vessels and have a high mortality rate between 70 and 90% [1, 3–5].…”

Section: Discussionmentioning

confidence: 99%

A rare opportunity for conservative treatment in a case of blunt trauma to the supradiaphragmatic inferior vena cava

Matthees

Mankin

Kalinkin

et al. 2013

Journal of Surgical Case Reports

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Injuries to the inferior vena cava (IVC) secondary to blunt trauma are rare and occur in only 1–10% of all blunt trauma patients. Management of these injuries has not been subjected to major studies, but several case reports and small retrospective studies have demonstrated that management can be tailored to the hemodynamic status of the patient; this is similar to the management of blunt liver injuries. Stable patients whose injuries have achieved local venous tamponade have been successfully treated without surgical intervention, while unstable patients require operative management. Regardless of patient status, however, IVC injuries are highly fatal with mortality rates between 70 and 90%. This report describes the case of a patient with a blunt traumatic injury to the supradiaphragmatic IVC with development of a pseudoaneurysm who was successfully managed conservatively.

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