Nonoperative management of contained retrohepatic caval injury.
Traumatic inferior vena cava (IVC) injuries are associated with high mortality rates, despite all improvements in the technical skills and prehospital and hospital care. Selective conservative management of the penetrating abdominal injuries involving IVC has not been widely discussed before. Here, we report a case of a young female with a single gunshot wound to her abdomen, who presented to our level 1 trauma center 10 minutes after injury and was hemodynamically stable. A computed tomographic scan revealed a large liver laceration with a trajectory through the liver and the IVC. The IVC was surrounded by a moderate amount of fluid, consistent with a contained retroperitoneal hematoma. We discuss the outcome of nonoperative management of this patient along with a review of the literature.
Department of Surgery, Louisiana State University Health Sciences Center, Shreveport, LA 71103-4228, USA.
Imtiaz R
IR
Khan
Alireza
A
Hamidian Jahromi
Faiza M
FM
Khan
Asser M
AM
Youssef
D005260:Female; D005440:Fluid Therapy; D006406:Hematoma / Q000628:therapy; D006439:Hemodynamics; D006801:Humans; D022125:Lacerations; D008099:Liver / Q000000981:diagnostic imaging / Q000293:injuries*; D008875:Middle Aged; D012187:Retroperitoneal Space; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging / Q000293:injuries* / Q000503:physiopathology; D014948:Wounds, Gunshot / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*