[Traumatic injuries of the inferior vena cava]

The authors analyse the results of surgical treatment of 21 patients with injury of the inferior vena cava seen at the Hospital of General Surgery. The mean age of patients was 33.7 years. Venous injuries were induced by cut wounds (14 casualties), gunshot wounds (5 patients) and blunt trauma (2 patients). The majority of patients were transported in a state of severe hemorrhagic shock which required intensive resuscitation measures. On laparotomy all the patients were found to have retroperitoneal hematomas. The infrarenal segment of the inferior vena cava was damaged in 17 patients, the renal segment in two and the suprarenal segment also in two patients. Seven patients presented with perforating wound of the vein. In 19 cases, injuries of the inferior vena cava were coupled with injury of other organs whereas in four casualties, they were associated with trauma of the visceral vessels. Vascular suture was applied in 17 casualties with trauma of the inferior vena cava, two patients underwent the replacement of its wall using an autogenous vein patch, and two patients were provided venous ligation. Nineteen patients underwent simultaneous rations on the involved caval and parenchymatous organs, visceral vessels. The postoperative lethality accounted for 38%. The causes of lethal outcomes are analyzed. The data obtained allow the conclusion casualties with injury of the inferior vena cava can be operated on successfully at the hospitals of general surgery. The pledge of success is the necessity of the training of general surgeons in the technologies of vascular reconstructive operations.