A Successful Management of Supra-Renal Inferior Vena Cava Injury Following Penetrating Trauma: A Case Report

Abstract

Penetrating trauma of the abdominal Inferior Vena Cava remains a life-threatening injury. Nearly half of patients with an injury of abdominal Inferior Vena Cava die before reaching the hospital. This makes injuries of IVC often fetal and the management of these injuries is usually challenging. Early hospital transfer, prompt diagnosis, rapid bleeding control and diminishing shock period remain significantly important factors that improve the survival rate. We report a successful surgical management of suprarenal inferior vena cava injury case and associated organ injuries following a stab knife wound.

Blunt inferior vena cava injury associated with AAST-grade V hepatic and renal injuries: A case report

“…Therefore, the mortality rate is approaching 100% for the injury to the supra hepatic IVC because the thoracic and abdominal cavities are involved simultaneously, and exposure and hemostasis are difficult to be archived in the presence of diaphragmatic muscle [2,3] . On the other hand, injury to the infrarenal segment of IVC is associated with the lowest mortality rate (23%) due to an easy approach to stop bleeding [3,4] . With retrohepatic caval injury, associated severe liver laceration is often seen [6] .…”

“…Survival in IVC injuries is related to three factors: major vessel injury, level of IVC injury, and any active bleeding during surgery, with the last factor most crucial [2] . Infrarenal IVC injury has the lowest mortality rate (23%) [4] , while suprahepatic IVC injury reaches a mortality rate of 100% [2] . Prompt surgical intervention and bleeding control to lower shock period are imperative for improving the survival rate [4] .…”

“…Infrarenal IVC injury has the lowest mortality rate (23%) [4] , while suprahepatic IVC injury reaches a mortality rate of 100% [2] . Prompt surgical intervention and bleeding control to lower shock period are imperative for improving the survival rate [4] . Contrast-enhanced computed tomography (CT) is the gold standard to evaluate the hemodynamic ally stable patients for the level of IVC injury and injuries to the other vessels and organs [1,3] .…”