Inferior Vena Cava Injuries—A Continuing Challenge
作者:
J. MILLIKAN,
ERNEST MOORE,
THOMAS COGBILL,
JEFFRY KASHUK,
期刊:
The Journal of Trauma: Injury, Infection, and Critical Care
(OVID Available online 1983)
卷期:
Volume 23,
issue 3
页码: 207-212
ISSN:0022-5282
年代: 1983
出版商: OVID
数据来源: OVID
摘要:
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.
点击下载:
PDF
(564KB)
返 回