Splenic Vein Turndown Repair in Superior Mesenteric Vein Trauma: A Reasonable Alternative

Phillips, Brett T.; Pasklinsky, Garri; Watkins, Ken W.; Vosswinkel, James A.; Tassiopoulos, Apostolos K.

doi:10.1177/1538574410390712

Cited by 7 publications

(5 citation statements)

References 12 publications

(15 reference statements)

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“…There are several cases in the literature of SMV repair using a splenic vein turndown repair [66]. Phillips [66] reported a case of splenic vein turndown repair in conjunction with distal pancreatectomy and splenectomy after blunt abdominal trauma, which resulted in good mesenteric perfusion and no congestion or edema. This repair can be used in patients with SMV injury who also sustained severe pancreatic and splenic trauma necessitating a distal pancreaticosplenectomy.…”

Section: Discussionmentioning

confidence: 99%

Trauma to the Superior Mesenteric Artery and Superior Mesenteric Vein: A Narrative Review of Rare but Lethal Injuries

et al. 2017

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Mesenteric vessels, including the superior mesenteric artery (SMA) and vein (SMV), provide and drain the rich blood supply of the midgut and hindgut. SMA and SMV injuries are rare and often lethal. Clinical management of these injuries is not well established, but treatment options include operative, non-operative, and endovascular strategies. A narrative review of the literature was conducted using MEDLINE Complete-EBSCO. Relevant studies, specifically those focusing on diagnosis and management of SMA and SMV injuries, were selected. Only original reports and collected series were selected to prevent duplication of cases. A search of the literature for mesenteric arterial injuries yielded 87 studies. Vessel-specific breakdown of the studies yielded 40 with SMA injuries and 41 with SMV injuries. These searches were winnowed to 26 individual studies, which were included in this collective review. Limitations of this study are similar to all narrative literature reviews: the dependence on previously published research and availability of references as outlined in our methodology. Although historically rare, mesenteric vessel injuries are seen with increasing incidence and continue to present a challenge to trauma surgeons due to their daunting mortality rates. Currently, universal treatment guidelines do not exist, but the various options for their management have been extensively reviewed in the literature.

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Section: Discussionmentioning

confidence: 99%

Trauma to the Superior Mesenteric Artery and Superior Mesenteric Vein: A Narrative Review of Rare but Lethal Injuries

et al. 2017

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“…The use of a splenic vein turndown technique has been successfully described in cases of SMV/PV trauma [9]. Phillips et al reported the use of the turndown technique in one patient to repair SMV traumatic avulsion, and in a literature review of 56 articles, identified five other trauma cases where the splenic vein turndown repair was used.…”

Section: Discussionmentioning

confidence: 99%

“…Phillips et al reported the use of the turndown technique in one patient to repair SMV traumatic avulsion, and in a literature review of 56 articles, identified five other trauma cases where the splenic vein turndown repair was used. Of the six patients, four survived the procedure with radiological evidence of portal venous flow postoperatively [9].…”

Section: Discussionmentioning

confidence: 99%

Splenic vein turndown for vascular reconstruction following pancreatic cancer resection in patients with high risk profile

Clout

Toh

Majid

et al. 2017

Int J Hepatobiliary Pancreat Dis

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Introduction: Vascular reconstruction is utilized following resections for pancreatic cancers with borderline resectability. This is defined by venous or partial superior mesenteric artery (SMA) involvement, where vessels are resected en bloc to achieve an R0 resection. There are many vascular reconstruction techniques post en bloc R0 resection, each with its own complication profile. The splenic turndown technique separates the vascular anastomosis from the pancreatic anastomosis, reducing the risk of vascular disruption should a pancreatic leak occur. Case Report: This is the first report in literature of the splenic vein turndown technique being utilized for vascular reconstruction post- pancreatic resection for borderline resectable pancreatic cancer. To date, splenic vein turndown repair has only been described in a trauma setting. In this case, splenic vein turndown was preferred as the patient was on long-term corticosteroids with a high risk of anastomotic leak. Conclusion: This case report showing that splenic vein turndown technique is a feasible option for vascular reconstruction post-pancreatic resection. The main disadvantage of this technique is high risk of segmental portal hypertension if the spleen is not removed concomitantly. For this reason, its utility should be restricted to patients at high risk of pancreatic leak.

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“…Although a few isolated case reports describe successful SMV revascularization through saphenous vein bypass shunts or splenic vein turndown, this is rare and occurs in high volume centers with the assistance of experienced vascular surgeons. [45][46][47]…”

Section: Superior Mesenteric Vein Injurymentioning

confidence: 99%

Superior Mesenteric Artery and Vein Injuries: Operative Strategies and Outcomes

Melmer

Clatterbuck

Parker

et al. 2021

Vasc Endovascular Surg

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Traumatic injuries to the mesenteric vessels are rare and often lethal. Visceral vessels, such as the superior mesenteric artery (SMA) and vein (SMV), supply blood to the small and large bowel by a rich system of collaterals. Because fewer than 100 such injuries have been described in the literature, they pose challenges in both diagnosis and management and can unfortunately result in high mortality rates. Prompt diagnosis, surgical intervention, and resuscitation can lead to improved outcomes. Here, we review the literature surrounding traumatic injuries of the SMA/SMV and discuss management strategies.

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Splenic Vein Turndown Repair in Superior Mesenteric Vein Trauma: A Reasonable Alternative

Abstract: There is little information regarding the feasibility and success of this technique in traumatic SMV disruption. Future studies are required to assess its role in abdominal vascular trauma.

Cited by 7 publications

References 12 publications

Trauma to the Superior Mesenteric Artery and Superior Mesenteric Vein: A Narrative Review of Rare but Lethal Injuries

Trauma to the Superior Mesenteric Artery and Superior Mesenteric Vein: A Narrative Review of Rare but Lethal Injuries

Splenic vein turndown for vascular reconstruction following pancreatic cancer resection in patients with high risk profile

Superior Mesenteric Artery and Vein Injuries: Operative Strategies and Outcomes

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