Inferior Vena Cava Ligation and Pancreaticoduodenectomy in a Patient With Penetrating Abdominal Trauma

Injury to the inferior vena cava (IVC) is often fatal. Pancreaticoduodenectomy for trauma is also rare. This case describes a patient who underwent both procedures.

A 30-year-old male presented status post gunshot to the abdomen. He was taken to the operating room and found to have 6 cm defect in the IVC, which was ligated. Despite resuscitation, the patient required emergent return to the OR where bleeding from the pancreaticoduodenal artery was noted in addition to injuries in the stomach, duodenum, and pancreas. He subsequently underwent a pancreaticoduodenectomy. He was discharged after a month-long hospital stay.

This case demonstrates that IVC ligation is a form of damage of control surgery. Pancreaticoduodenectomy is rarely performed during the index operation for trauma patients. Patient with injuries to the pancreaticoduodenal complex can be life-threatening if not rapidly controlled. This patient is a rare example of someone who survived two morbid trauma surgery interventions.