title: Use of an atriocaval shunt in a trauma patient: first reported case in Hawai'i.
abstract: BACKGROUND
  Traumatic injuries to the retrohepatic vena cava are typically fatal. Emergent access to this area is difficult and patients typically exsanguinate before the injury can be identified and fixed.
  
  
  OBJECTIVE
  To report the use of an atriocaval shunt in the repair of an injury to the retrohepatic vena cava from a gunshot wound.
  
  
  METHODS
  A 24-year-old man was shot in his right chest suffering a penetrating injury to the liver and inferior vena cava. Surgical repair was performed with the aid of an atriocaval shunt fashioned from a chest tube. He survived and recovered without incident.
  
  
  CONCLUSIONS
  Atriocaval shunting maybe a life-saving option for uncontrolled hemorrhage from injuries to the retrohepatic vena cava.
authors.affiliation: The University of Hawai'i Surgical Residency Program, and The Queen's Medical Center, Honolulu, HI, USA. jjclark_md@yahoo.com
authors.forename: Justin J
authors.initials: JJ
authors.lastname: Clark
authors.forename: Susan
authors.initials: S
authors.lastname: Steinemann
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Lau
mesh_terms: D000007:Abdominal Injuries / Q000601:surgery*; D006470:Hemorrhage / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D008297:Male; D011170:Portasystemic Shunt, Surgical / Q000379:methods*; D014682:Vena Cava, Inferior / Q000293:injuries* / Q000601:surgery; D014948:Wounds, Gunshot / Q000601:surgery*; D055815:Young Adult