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Inferior vena cava injury repair, a successful outcome
S Adhikary1, V C Shakya, K Dhungel
1Department of Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal. surgery_bpkihs@yours.com
Insights
Inferior vena cava (IVC) injuries are rare but life-threatening. Prompt management and surgical repair are crucial for survival in patients with abdominal stab wounds affecting the IVC.
Area of Science:
- Vascular Surgery
- Trauma Surgery
- Surgical Critical Care
Background:
- Injuries to the inferior vena cava (IVC) are uncommon but associated with high mortality.
- Retroperitoneal vascular injuries, particularly to the IVC, pose significant diagnostic and therapeutic challenges.
Observation:
- A young male presented with a near-transected IVC following an abdominal stab injury.
- The patient required immediate surgical intervention and aggressive perioperative management.
Findings:
- Successful repair of a near-transected IVC was achieved through timely surgical judgment and aggressive management.
- The case highlights the critical importance of prompt diagnosis and intervention in managing severe IVC injuries.
Implications:
- This case underscores the need for a high index of suspicion for IVC injuries in penetrating abdominal trauma.
- Effective management strategies involving aggressive resuscitation and expert surgical repair can improve outcomes for these rare, devastating injuries.
Abstract:
Inferior ver a cava (IVC) injuries are very very infrequent; yet it still happens to be the most frequently injured retroperitoneal vascular structure. Fifty percent of the patients can't even make it to the hospital. Even when half of them manage to attend the hospital the mortality rates for the great vessel injury are still very high perhaps due to the low index of suspicion, delayed or inadequate volume resuscitation, difficulty in diagnosis and also due to some technical problems associated in its repair. We present a young male with an abdominal stab injury who had a near transected inferior vena cava at operation. Aggressive perioperative management and the correct judgement by our team at the right time possibly made the patient survive. The rarity of this condition and a review of the literature with some discussion are presented.
