Successful repair of injured hepatic veins and inferior vena cava following blunt traumatic injury, by using cardiopulmonary bypass and hypothermic circulatory arrest.
Traumatic injury to the retrohepatic veins continues to carry high mortality rates. In the last few decades various management strategies have been proposed. However, treatment of such injuries still remains highly variable and technically challenging due to the surgically inaccessible location of these vessels and the consequent difficulty controlling bleeding. We report a successful repair of complete transection of the two main extraparenchymal hepatic veins and laceration of the retrohepatic inferior vena cava using cardiopulmonary bypass (CPB) and hypothermic circulatory arrest (HCA) following blunt abdominal trauma. Immediate CPB with or without HCA can be life-saving and should be considered for patients with complex isolated retrohepatic venous injuries.
Department of Cardiovascular and Thoracic Surgery, Nicosia General Hospital, Nicosia, Cyprus. ckaoutzanis@gmail.com
Christodoulos
C
Kaoutzanis
Erotokritos
E
Evangelakis
Chrysostomos
C
Kokkinos
Gavriel
G
Kaoutzanis
D000063:Accidents, Traffic; D000328:Adult; D002315:Cardiopulmonary Bypass; D050792:Circulatory Arrest, Deep Hypothermia Induced; D006503:Hepatic Veins / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D010690:Phlebography / Q000379:methods; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014656:Vascular Surgical Procedures; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D014949:Wounds, Nonpenetrating / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*