TRAUMA.ORG: Classic Cases: Inferior Vena Cava Injury: Lateral Repair

IVC INJURIES
DAMAGE CONTROL
CASE PRESENTATIONS

CLASSIC CASES

Infrahepatic Inferior Vena Cava injury
Lateral repair

Case Presentation
Woman, 30 y old, sustained a gunshot wound to the right upper quadrant. She was and remained hemodynamically normal since the admitance in the emergency room.

At laparotomy, the bullet was found to have penetrated the anterior and posterior surfaces of the stomach. There was minimal intraperitoneal blood but there was a right retroduodenal haematoma. The head of the pancreas was injurede (without injury to the main pancreatic duct) and the inferior vena cava was injured just below the junction with the right renal vein.


Gunshot entry wound, right upper quadrant	Anterior stomach injury (repaired)

A medial visceral rotation was performed to obtain control the infrarenal vena cava with a vascular clamp. The cephalad control was performed by compression of the reno-caval junction.


Right medial visceral rotation

A lateral wall repair was completed with a simple running suture.


Lateral wall of IVC injury (repaired)


The culprit

The gastric wounds were repaired by simple suture. Total intraoperative blood loss was 400ml, and she had no post-operative complications.

Discussion & References

For discussion and references on the management of IVC injuries see the entry in the Open Library of Trauma - Inferior Vena Cava Injuries

trauma.org (10:4) April 2005