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Injuries to the azygous venous system
Matthew J Wall1, Kenneth L Mattox, Michael E Debakey
1Department of Surgery, Baylor College of Medicine, Houston, Texas 77030, USA. mwall@bcm.tmc.edu
The Journal of Trauma
|March 2, 2006
Summary
Injuries to the azygous venous system, though rare, carry a high mortality rate. Early consideration of this system is crucial for managing posterior mediastinal hemorrhage from penetrating trauma.
Area of Science:
- Trauma Surgery
- Vascular Surgery
- Thoracic Surgery
Background:
- Azygous venous system injuries are uncommon but present significant morbidity and mortality.
- These injuries are comparable in severity to those of thoracic great vessels.
Purpose of the Study:
- To analyze the characteristics and outcomes of azygous venous system injuries.
- To highlight diagnostic challenges and emphasize early consideration of these injuries.
Main Methods:
- Retrospective review of a vascular injury database over 40 years.
- Analysis of 22 identified cases of azygous venous system trauma.
Main Results:
- 22 injuries identified (21 azygous vein, 1 hemiazygous vein), primarily from penetrating trauma (19 GSW, 3 stab wounds).
- Overall mortality rate of 36% (8 of 22 patients).
- All patients had associated injuries, notably lung injury in every case.
Conclusions:
- Azygous venous system injuries are associated with significant lethality.
- Anterior surgical incisions can complicate exposure and diagnosis.
- Continued posterior thoracic hemorrhage suggests potential azygous system injury, necessitating early consideration.
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