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Portal vein injuries.

R F Buckman¹, A S Pathak, M M Badellino

¹Department of Surgery, Temple University School of Medicine, Temple University Hospital, Philadelphia, Pennsylvania 19140, USA.

The Surgical Clinics of North America

|January 5, 2002

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Penetrating trauma to the portal vein is often fatal due to severe bleeding. Portal vein ligation is a safe alternative to complex repair, with careful postoperative care essential.

Area of Science:

Vascular Surgery
Trauma Surgery
Surgical Anatomy

Background:

Portal vein injuries are uncommon but associated with high mortality rates.
Exsanguination during surgery is a primary cause of death.
Understanding anatomy and injury patterns is crucial for management.

Purpose of the Study:

To review the management of portal vein wounds.
To evaluate surgical repair versus ligation techniques.
To highlight critical aspects of postoperative care.

Main Methods:

Review of literature on portal vein trauma.
Analysis of surgical strategies for hemorrhage control.
Discussion of anatomical considerations.

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Main Results:

Lateral repair is preferred when feasible, but portal ligation is a safe alternative.
Multiple vessel injuries are common in portal vein trauma.
Postoperative care requires aggressive fluid resuscitation and monitoring for bowel infarction.

Conclusions:

Portal vein ligation is a viable and safe option for managing portal vein injuries.
Complex repairs should be reserved for specific contraindications to ligation.
Vigilant postoperative management is critical to reduce complications.