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Tips & tricks for managing caval and retrohepatic injuries

Kmattox kmattox at aol.com
Wed May 4 01:42:11 BST 2011


Congrats.    Thanks.    I would like.  

k




Sent from my iPhone

On 2011-05-03, at 6:23 PM, "Dudick, Catherine" <Catherine.Dudick at atlanticare.org> wrote:

> After a quick packing of a penetrating retrohepatic caval injury, I
> called IR to help and they successfully deployed an endovascular aortic
> extension graft that bridged the leaking area. We did not use any
> subsequent systemic anticoagulation. 
> 
> 
> 
> After Dr. Gilani's intriguing lectures at the Trauma, Critical Care and
> Acute Care Surgery 2011 conference in Las Vegas, I can easily conceive
> of doing this in the OR, not the IR suite, essentially combining an open
> and endovascular procedure in the hands of the trauma surgeon. Dr.
> Gilani stressed how important endovascular skills are to the trauma
> surgeon and how useful they can be, as this patient demonstrates.
> 
> 
> 
> I probably can find the pics and email them to you if you like.
> 
> 
> 
> Cathy Dudick
> 
> 
> 
> ------------------------------
> 
> 
> 
> Message: 2
> 
> Date: Tue, 3 May 2011 13:58:28 +0100
> 
> From: Karim Brohi <karim at trauma.org>
> 
> Subject: Tips & tricks for managing caval and retrohepatic injuries
> 
> To: Trauma and Critical Care mailing list <trauma-list at trauma.org>
> 
> Message-ID: <BANLkTinY8PGNOdUFOsVt6MrCv6nuv3-Lgg at mail.gmail.com>
> 
> Content-Type: text/plain; charset=ISO-8859-1
> 
> 
> 
> 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!
> 
> 
> 
> Karim
> 
> 
> 
> --
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