Multiinstitutional Experience with The Management of Superior Mesenteric Artery Injuries

Asensio, Juan A.; Britt, L. D.; Borzotta, Anthony P.; Peitzman, Andrew B.; Miller, Frank B.; Mackersie, Robert C.; Pasquale, Michael D.; Pachter, H. Leon; Hoyt, David B.; Rodriguez, Jorge Luis; Falcone, Robert E.; Davis, Kimberly; Anderson, John T.; Ali, Jameel; Chan, Linda S.

doi:10.1016/s1072-7515(01)01044-4

Cited by 114 publications

(92 citation statements)

References 16 publications

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“…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]. Furthermore, multiple associated injuries are typical, and act as important contributors to patient outcome [3][4][5].…”

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%

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

Ball

Kirkpatrick

Smith³

et al. 2007

Eur J Trauma Emerg Surg

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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.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

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

Ball

Kirkpatrick

Smith³

et al. 2007

Eur J Trauma Emerg Surg

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show abstract

“…Penetrating mechanisms are responsible for the vast majority of injuries accounting for 70-95% of patients Asensio, et al, 2002;Hoyt, et al, 2001;Mattox, et al, 1989). Of blunt causes motor vehicle crashes are the most common followed by falls from height and pedestrians struck by vehicles (Asensio, et al, 2001b;Bertrand, et al, 2008;Mirvis & Shanmuganathan. 2007;Wintermark, et al, 2002).…”

Section: Thoraco-abdominal Vascular Injurymentioning

confidence: 99%

“…Increasingly CT scanning is being utilized for diagnosis of thoraco-abdominal vascular injury. Intravascular interventions such as covered stents have been increasingly utilized for treatment of thoracic, subclavian and iliac arterial injuries, structures which have classically been difficult to expose and treat surgically (Asensio, et al, 2001a;Boufi, et al, 2011;Carrick, et al, 2010;Castelli, et al, 2005;Cestero, et al, 2009;Demetriades, et al, 2008a;Demetriades, et al, 2008b;Starnes & Arthurs. 2006).…”

Section: Thoraco-abdominal Vascular Injurymentioning

confidence: 99%

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Kobayashi¹,

Coimbra²

2012

Vascular Surgery

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Analysis of 185 Iliac Vessel Injuries

Asensio¹

2003

Arch Surg

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Patients: One hundred forty-eight patients with 185 iliac vessel injuries. Outcome Measures: Survival and mortality, analyzed by univariate and logistic regression. Results: Admission mean ± SD systolic blood pressure was 81 ± 42 mm Hg, mean Revised Trauma Score was 6.0±2.8, and mean Injury Severity Score was 20.0±9.5. The mechanism of injury was penetrating in 140 patients (95%) and blunt in 8 (5%). The mean estimated blood loss was 6246 ± 6174 mL. Of the 185 injured vessels, 71 (99%) of 72 iliac arteries were repaired, 101 (89%) of 113 iliac veins were ligated, and 12 (11%) of 113 iliac veins were repaired. Overall survival was 51% (76/148). Mortality was 82% (49/72) in patients with exsan

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Multiinstitutional Experience with The Management of Superior Mesenteric Artery Injuries

Cited by 114 publications

References 16 publications

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

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

Vascular Trauma: New Directions in Screening, Diagnosis and Management

Analysis of 185 Iliac Vessel Injuries

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