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Inferior vena cava injuries--a continuing challenge.

J S Millikan, E E Moore, T H Cogbill

    The Journal of Trauma
    |March 1, 1983
    PubMed
    Summary

    Abdominal vena cava trauma has high mortality. Key factors for poor survival include shock, multiple vascular injuries, and retrohepatic wounds, highlighting the need for rapid resuscitation and early identification of associated injuries.

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    Area of Science:

    • Trauma Surgery
    • Vascular Surgery
    • Emergency Medicine

    Background:

    • Abdominal vena cava trauma carries a high mortality rate exceeding 33%.
    • Despite advances in care, survival remains a challenge.

    Purpose of the Study:

    • To analyze outcomes and identify predictors of survival in patients with abdominal vena cava injuries.
    • To evaluate the impact of injury location and associated vascular trauma on mortality.

    Main Methods:

    • Retrospective review of 58 patients treated for vena cava injuries between 1974 and 1981.
    • Analysis of injury mechanisms (gunshot, stab, blunt trauma), injury location, and associated vascular injuries.

    Main Results:

    • Overall mortality was 38%.

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  • Predictors of poor survival included shock on arrival, multiple abdominal vascular injuries, and retrohepatic injuries.
  • Survival rate for retrohepatic wounds was only 17%; 92% of deaths involved associated major vascular trauma.

    • Conclusions:

    • Rapid resuscitation, early operation, and prompt assessment for associated vascular injuries are crucial.
    • Improving survival for blunt retrohepatic vena cava and hepatic vein trauma remains a significant clinical dilemma.