Penetrating injuries of the inferior vena cava

Balachandran, G; Bharathy, Kishore Gurumoorthy Subramanya; Sikora, Sadiq S.

doi:10.1016/j.injury.2020.08.022

Cited by 17 publications

(10 citation statements)

References 43 publications

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“…It has been reported that the incidence of complications associated with abdominal Trocar insertion is about 0.8 for every 1000 insertions performed [ 2 ]. Such conditions are more likely to happen at the departments of general surgery (the incidence being 0.5–5%) [ 3 ], hepatobiliary surgery, gynecology, chest surgery, and cardiology, where mature minimally invasive procedures, including radiofrequency ablation for atrial fibrillation, are performed [ 4 – 6 ]. Noniatrogenic IVC injuries: China has experienced rapid technological development in recent years, accompanied by a growing incidence of IVC injuries associated with complex trauma due to accidents.…”

Section: Introductionmentioning

confidence: 99%

Clinical Manifestations of Inferior Vena Cava Injuries and the Progress of Emergency Treatment

Liu

Zhang

Xiang³

et al. 2022

Journal of Healthcare Engineering

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In this paper, clinical manifestations of inferior vena cava injuries and the progress of emergency treatment are presented. Inferior vena cava (IVC) is the large vein returning venous blood from the lower limbs and pelvic and abdominal cavities to the right atrium of the heart. The clinical manifestations of IVC injuries include shock, progressive hemorrhage, air embolism, retroperitoneal hematoma, active bleeding, and hemoperitoneum. The patients may be combined or not combined with injuries to other organs or even die. Routine examination methods for IVC injuries include general examination, color Doppler ultrasound, abdominal contrast-enhanced CT, magnetic resonance spectroscopic imaging (MRSI), and IVC angiography. These examinations are usually performed to confirm the diagnosis. Surgical treatment is the primary emergency treatment for this condition. Increasing the blood volume and symptomatic treatment are auxiliary treatments. The surgeries and repairs for IVC injuries are currently under investigation. Experimental results have verified the exceptional performance of the proposed scheme.

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Section: Introductionmentioning

confidence: 99%

Clinical Manifestations of Inferior Vena Cava Injuries and the Progress of Emergency Treatment

Liu

Zhang

Xiang³

et al. 2022

Journal of Healthcare Engineering

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“…The former produces an extensive tangential area of vessel transection, and the latter results in linear laceration. [ 63 ] Combined aortic and inferior vena cava injury mortality are around 93%. [ 55 ] Infrarenal segment (39%) followed by retrohepatic (19%), infrahepatic (18%), juxtarenal (17%), and suprahepatic IVC (7%) are the common sites of IVC segments prone to injury.…”

Section: Penetrating Abdominopelvic Injuriesmentioning

confidence: 99%

“…[ 64 ] Locations of IVC injury such as retroperitoneum and posterior surface of pancreas, duodenum, and liver may provide tamponade effect to the IVC bleed; however, the patients can exsanguinate to death if the tamponade is decompressed and not controlled promptly. [ 63 ]…”

Section: Penetrating Abdominopelvic Injuriesmentioning

confidence: 99%

Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds

Gopireddy

Kee-Sampson

Vulasala

et al. 2023

JCIS

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In the United States, gunshot wounds (GSWs) have become a critical public health concern with substantial annual morbidity, disability, and mortality. Vascular injuries associated with GSW may pose a clinical challenge to the physicians in the emergency department. Patients demonstrating hard signs require immediate intervention, whereas patients with soft signs can undergo further diagnostic testing for better injury delineation. Although digital subtraction angiography is the gold standard modality to assess vascular injuries, non-invasive techniques such as Doppler ultrasound, computed tomography angiography, and magnetic resonance angiography have evolved as appropriate alternatives. This article discusses penetrating bodily vascular injuries, specifically ballistic and stab wounds, and the corresponding radiological presentations.

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“…Other recent reports also document that the mortality of an injury to the IVC is in the range of 30 to 70%, depending on the anatomic level, where retrohepatic injuries are known to have high mortality rate, with more distal injuries being associated with better survivorship. [7][8][9][10][11][12] Due to the physiologic state of these patients at presentation, frequent concomitant injuries, and known high mortality, surgical management often includes damage control, commonly including IVC ligation. 7,10,13 In the review by Sullivan et al 14 in 2010, this was demonstrated to be an acceptable method for rapid control of hemorrhage, and long-term sequelae were uncommon among survivors.…”

Section: Introductionmentioning

confidence: 99%

Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment

Stonko

Azar

Betzold

et al. 2021

The American Surgeon™

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Introduction Injuries to the inferior vena cava (IVC), while uncommon, have a high mortality despite modern advances. The goal of this study is to describe the diagnosis and management in the largest available prospective data set of vascular injuries across anatomic levels of IVC injury. Methods The American Association for the Surgery of Trauma PROspective Observational Vascular Injury Treatment (PROOVIT) registry was queried from November 2013 to January 2019. Demographics, diagnostic modalities, injury patterns, and management strategies were recorded and analyzed. Comparisons between anatomic levels were made using non-parametric Wilcoxon rank-sum statistics. Results 140 patients from 19 institutions were identified; median age was 30 years old (IQR 23-41), 75% were male, and 62% had penetrating mechanism. The suprarenal IVC group was associated with blunt mechanism (53% vs 32%, P = .02), had lower admission systolic blood pressure, pH, Glasgow Coma Scale (GCS), and higher ISS and thorax and abdomen AIS than the infrarenal injury group. Injuries were managed with open repair (70%) and ligation (30% overall; infrarenal 37% vs suprarenal 13%, P = .01). Endovascular therapy was used in 2% of cases. Overall mortality was 42% (infrarenal 33% vs suprarenal 66%, P<.001). Among survivors, there was no difference in first 24-hour PRBC transfusion requirement, or hospital or ICU length of stay. Conclusions Current PROOVIT registry data demonstrate continued use of ligation extending to the suprarenal IVC, limited adoption of endovascular management, and no dramatic increase in overall survival compared to previously published studies. Survival is likely related to IVC injury location and total injury burden.

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Penetrating injuries of the inferior vena cava

Cited by 17 publications

References 43 publications

Clinical Manifestations of Inferior Vena Cava Injuries and the Progress of Emergency Treatment

Clinical Manifestations of Inferior Vena Cava Injuries and the Progress of Emergency Treatment

Imaging of penetrating vascular trauma of the body and extremities secondary to ballistic and stab wounds

Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment

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