Surgical Management of Aortic Trauma

Tw, Allen; Gj, Reul; Morton,; Ac, Beall

doi:10.1097/00005373-197210000-00005

Cited by 24 publications

(3 citation statements)

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“…Irreversible shock secondary to massive bleeding is, by far, the most common cause of death. [1][2][3][4][5][6][7][8][9][10] Successful surgical management of such devastating injuries depends on adequate resuscitation and prompt surgical intervention with expedited proximal and distal control of the injured vessel.…”

Section: Introductionmentioning

confidence: 99%

Outcome from Traumatic Injury of the Portal and Superior Mesenteric Veins

Coimbra

Filho²,

Nesser³

et al. 2004

Vasc Endovascular Surg

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Traumatic injuries to the portal vein (PV) and superior mesenteric vein (SMV) are rare and carry a high mortality rate, and the best approach and method of repair is still subject to debate. The objective of the present study was to analyze risk factors for mortality in portal and superior mesenteric venous injuries. A retrospective analysis of 18 patients during a 5-year period was performed. Mechanism of injury, shock upon admission, Revised Trauma Score (RTS), Injury Severity Score (ISS), intraoperative fluid requirements, classification of venous injury severity, and associated injuries were analyzed as potential predictors of outcome. All patients were male, 9 were victims of gunshot wounds, and 11 were in shock at the time of admission. Eight patients sustained PV, and 12 sustained SMV injuries. The great majority of patients had more than 1 associated injury and 61% had an associated vascular injury. Mortality rate correlated with injury severity. Overall mortality rate was 72%. Nonsurvivors had higher ISS than survivors (24 +/-0.4 and 20 +/-1.7, respectively; p = 0.006). Uncontrollable intraoperative hemorrhage was the cause of death in 5 of 13 patients (38.4%). Six patients died during the postoperative period from complications of prolonged shock and multiple organ failure, and 2 died of sepsis. The physiologic status upon admission, the number of associated injuries, and the severity of the vascular injury are the most important factors related to mortality in PV and SMV injuries.

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Section: Introductionmentioning

confidence: 99%

Outcome from Traumatic Injury of the Portal and Superior Mesenteric Veins

Coimbra

Filho²,

Nesser³

et al. 2004

Vasc Endovascular Surg

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“…Although abdominal vascular injuries due to missile bullets are less common compared to other injuries, they have a high mortality rate (1)(2)(3)(4)(5). Due to the difficulties in managing the treatment of such events, most surgeons fear facing a missile wound causing vascular injury in the abdomen (3-7).…”

Section: Introductionmentioning

confidence: 99%

“…There are many factors affecting mortality rates such as; transportation time, type of injury, visceral organ damage, amount of blood loss and surgical experience of the medical and surgical teams (1-3). The success in management depends on the control of bleeding following rapid exposure and establishing revascularization using appropriate surgical techniques (4)(5)(6)(7)(8). This article will be focused on the factors affect-ing the outcomes of abdominal vascular injuries and its coincidence with visceral organ damage.…”

Section: Introductionmentioning

confidence: 99%

Abdominal Vascular Injuries Due to Missile Wounds

Bingöl¹

2014

JAREM

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Objective: Although abdominal vascular injuries due to missile bullets are less common compared to other injuries, they are of great importance because of the high mortality rate. There are many factors affecting the mortality rate such as; transportation time, type of injury, visceral organ damages, amount of blood loss and surgical experience of the medical and surgical team. The aim of this study is to assess the mortality rate of abdominal vascular injury caused by the bullets of rifles when visceral organs injury is associated with vascular injury.Methods: Between 1993-2008, registries in surgery department of the hospitals affiliated to Başkent University were scanned and 27 abdominal vascular injuries of a total of 212 abdominal wound cases were detected. The mean age was 24±12 years (22 men and 5 women). Ages ranged from 12 to 58 years. The cause of injury was a mine explosion and firearm in one patient, and firearms in the others. All cases had vascular injuries. 16 cases had major venous injuries, 6 had major arterial injuries and the remaining 5 cases have major arterial and venous injuries.Results: Fifty-four abdominal organ injuries were determined. Twenty-seven of these 54 patients had abdominal vascular injuries. Only one patient's systolic blood pressure was higher than 50 mmHg in the preoperative period. The remaining patients had lower systolic blood pressures. In addition, the blood pressure of ten patients could not be determined during admission to the emergency department. Major venous injuries had the worst preoperative hemodynamics. Twenty-three of 54 patients had liver injury (42.59%), stomach injury in 14 patients (25.92%), right kidney injury in 7 patients (12.96), left kidney injury in 5 patients (9.25%) and multiple organ injuries in 2 patients (3.7%). Eight patients underwent vascular ligation, primary repair was done in 12 patients and graft interposition was done in 7 patients. However, 5 cases died before surgical intervention. Out of 5 deaths, one patient died because of sepsis (postoperative 2 nd day), one patient died from VCI laceration, sepsis occurred in one, 1 died from renal venous trauma, 1 from vena porta injury and one from cerebral hemorrhage associated with abdominal vascular injury. The management of inferior caval vein injuries, which are responsible for 60% of all deaths, were the most challenging. Yöntemler: 1993-2008 yılları arasında batına isabet eden kurşun yaralanmalı toplam 212 hasta Başkent Üniversitesi'ne bağlı hastanelerin cerrahi departmanlarına müracaat etmiş olup bu hastaların 27'sinde batın içi damar yaralanması mevcuttu. Toplam 27 hastanın (22 erkek ve 5 bayan) ortalama yaşları 24±12 idi (12-58 yaş). Bir hastada yaralanma mayın patlaması ve ateşli silah yaralanması sonucu oluşmuştu, diğer hastalarda yaralanma ateşli silah yaralanmasına bağlı idi. Hastaların hepsinde ateşli silah yaralanmasına bağlı damar hasarı mevcuttu. Vakaların 16 sında büyük ven yaralanması, 6'sında büyük arter yaralanması ve diğer 5 vakada ise hem büyük arter hemde büyük...

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Injuries of the Great Intrathoracic Vessels

Glinz

1981

Chest Trauma

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Surgical Management of Aortic Trauma

Cited by 24 publications

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Outcome from Traumatic Injury of the Portal and Superior Mesenteric Veins

Outcome from Traumatic Injury of the Portal and Superior Mesenteric Veins

Abdominal Vascular Injuries Due to Missile Wounds

Injuries of the Great Intrathoracic Vessels

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