[Repair of a suprahepaticocaval injury under extracorporeal circulation].
The case of a 29-year old man who presented with haemorrhage from hepatic veins and the retrohepatic vena cava is reported. On the belief that a conventional technique would be dangerous, total extracorporeal circulation was used as a supportive procedure. The method facilitated anatomic definition of the venous injuries. The repair could then be calmly and precisely carried out because of a practically bloodless operative field. The procedure was well tolerated and the postoperative course was uneventful; the patient was discharged 15 days later. Many surgical techniques have been described for the repair of traumatic injuries of the inferior vena cava and hepatic veins, but all with a high level of peroperative mortality. So, cardiopulmonary bypass and hypothermia seemed to be a useful procedure. However, some points need further consideration: heparin administration may promote bleeding from other lesions and, in the case of associated gastrointestinal injuries, the risk of major septic dissemination is great.
D000328:Adult; D004630:Emergencies; D005112:Extracorporeal Circulation; D006503:Hepatic Veins / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008099:Liver / Q000293:injuries* / Q000601:surgery; D008297:Male; D014682:Vena Cava, Inferior / Q000293:injuries* / Q000601:surgery
Réparation d'un traumatisme sus-hépatico-cave sous circulation extracorporelle.