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Summary
Wounds to the portal or superior mesenteric veins have a high mortality rate (57%). Survival is linked to specific injury types and less severe shock, with venous repair patency being a concern.
Area of Science:
- Vascular surgery
- Trauma surgery
- Gastrointestinal surgery
Background:
- Injuries to the portal vein and superior mesenteric vein are critical vascular traumas.
- These injuries often present with significant bleeding and high mortality rates.
Purpose of the Study:
- To analyze outcomes and survival factors for patients with portal and/or superior mesenteric vein injuries.
- To evaluate the effectiveness of different repair strategies and their long-term patency.
Main Methods:
- Retrospective review of 47 cases of portal and/or superior mesenteric vein injuries over 16 years.
- Analysis of patient demographics, injury characteristics, management strategies, and outcomes.
- Assessment of survival rates and factors influencing mortality.
Main Results:
- Overall mortality was 57%.
- Survival was highest for isolated superior mesenteric vein injuries, repairable by lateral phleborrhaphy, without other major vascular trauma, and with minimal shock.
- Hemorrhagic shock and uncontrollable bleeding were primary causes of death.
- Limited follow-up showed low patency rates after venous repair.
Conclusions:
- Superior mesenteric vein injuries carry a high mortality, influenced by injury severity and associated trauma.
- Lateral phleborrhaphy offers better survival but has questionable long-term patency.
- Venous ligation may be a viable alternative when complex repair is not feasible or successful.