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Tips & tricks for managing caval and retrohepatic injuries

Karim Brohi karim at trauma.org
Tue May 3 13:58:28 BST 2011

The list has been a bit quiet recently so here's a quickie - I'm
giving a talk tomorrow at the Australasian Surgical Congress on the
management of inferior vena cava and retrohepatic venous injuries and
it seems to me that this is one area in particular where surgeons have
developed their own tips, tricks or techniques to manage thiese
injuries.  So does anyone have any golden nuggets of tools or
manoevres or anyting that gets them out of trouble, makes venous
control/repair easier, etc?

I have a couple - here's one of mine: I was always taught to use
spongesticks to control bleeding from a caval injury by pressing down
on the cava proximally and distally.  I find langenbeck retractors are
much more effective (the flat bit pressing down against the spine) for
this purpose.

I have more - but you'll need to show me yours first!


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