The problems of haemorrhage due to trauma from large vessels in the abdomen

The major problems of blood loss from large vessels in the peritoneal cavity because of trauma in 48 patients are discussed. There were 21 patients with inferior vena-caval injuries, and 8 with injuries of the aorta. Bleeding from other large vessels was also encountered. The problems relate to rapid transport to hospital, early recognition of bleeding, energetic resuscitation--including rapid replacement of blood, tamponade of bleeding areas until the sites of bleeding vessels can be identified, or tamponade or temporary clamping of the aorta or inferior vena cava proximally and distally.