Penetrating abdominal vena cava injuries.
OBJECTIVE
The surgical management and outcome of abdominal vena cava (AVC) injuries is presented. STUDY DESIGN, PATIENTS AND METHODS: A retrospective record review of patients with AVC injuries treated in the Trauma Unit at Groote Schuur Hospital between January 1999 and December 2003 was undertaken. Demographic data, mechanism of injury, surgical management, associated injuries, duration of hospital stay, complications and mortality were extracted from patient records. Patients with acute peritonitis and/or shock underwent emergency laparotomy.


RESULTS
Forty-eight patients with AVC injuries were identified. Gunshot wounds accounted for 45 (94%) injuries. The mean weighted revised trauma score, injury severity score (ISS) and penetrating abdominal trauma index (PATI) were 6.3, 24 and 42, respectively. The AVC injury was infrarenal and suprarenal in 41 and seven patients, respectively. Thirty injuries were ligated. There were 15 deaths (31%). Significant differences between survivors and non-survivors included ISS, preoperative hypotension and blood transfusion requirements, whereas site of injury, PATI, and surgical management did not.


CONCLUSIONS
Abdominal vena cava injuries are associated with a high mortality. Ligation of the AVC in critically ill patients is a feasible and life-saving option.
Navsaria
P H
PH
Trauma Unit, Groote Schuur Hospital and Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa. navsaria@uctgsh1.uct.ac.za
de Bruyn
P
P
Nicol
A J
AJ
D000007:Abdominal Injuries / Q000453:epidemiology / Q000601:surgery; D000293:Adolescent; D000328:Adult; D001458:Bandages; D001803:Blood Transfusion / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007022:Hypotension / Q000150:complications; D007902:Length of Stay; D008026:Ligation; D008297:Male; D008875:Middle Aged; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013019:South Africa / Q000453:epidemiology; D015599:Trauma Severity Indices; D014682:Vena Cava, Inferior / Q000293:injuries* / Q000601:surgery; D014950:Wounds, Penetrating / Q000453:epidemiology* / Q000601:surgery