title: Injury to Azygos Venous System: A Co-Existing Injury in High-Impact Lethal Trauma.
abstract: BACKGROUND
  About 50 cases of azygos venous system injuries following civilian trauma have been published in current literature. The purpose of our study was to investigate the incidence of these injuries, the causative mechanism and type of trauma, the co-existing injuries, and the mortality rate in our institution.
  
  
  METHODS
  We performed a retrospective review of all trauma patients who were admitted to the surgical department of the General Hospital of Rethymno during an 11-year period. Our study included patients arriving at our institution dead or alive with an azygos venous system injury following blunt or penetrating civilian trauma.
  
  
  RESULTS
  Seven patients-five men and two women-were identified with azygos venous system injuries. Five had an azygos vein laceration, one suffered from both azygos and hemiazygos vein lacerations, and the last one had sustained hemiazygos and accessory hemiazygos vein injuries. All of them suffered from a blunt trauma. Three arrived at our hospital in extremis, and all died within 24 h despite our resuscitation attempts. All of our patients were polytrauma patients. All of them had co-existing torso injuries which were severe in all but one case, three of them suffered also from serious head injuries, and all but one had at least serious extremity's injuries.
  
  
  CONCLUSIONS
  Azygos venous system injuries are rare, although it seems that they are more frequent than current literature would indicate. Blunt trauma mechanism seems to be predominant in civilian trauma setting, and the patients have usually sustained a lot of serious and severe co-existing injuries with high resultant lethality.
authors.affiliation: Department of Forensics Sciences, University Hospital of Heraklion Crete, Staurakion Voutes, 71110, Heraklion, Crete, Greece.
authors.forename: Antonios
authors.initials: A
authors.lastname: Papadomanolakis
authors.affiliation: Department for Thoracic and Visceral Surgery, GPR Hospital, August-Bebel-Str.49, 65428, Ruesselsheim, Germany. leniwtheod@gmail.com.
authors.forename: Eleni
authors.initials: E
authors.lastname: Theodoridou
authors.affiliation: Surgical Department, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece.
authors.forename: Nikistratos
authors.initials: N
authors.lastname: Vogiatzis
authors.affiliation: Intensive Care Unit, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Pentheroudaki
authors.affiliation: Surgical Department, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece.
authors.forename: Despoina
authors.initials: D
authors.lastname: Daskalaki
authors.affiliation: Surgical Department, General Hospital of Rethymno, Trantalidou 17, 74100, Rethymno, Greece.
authors.forename: Evangelos D
authors.initials: ED
authors.lastname: Lolis
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001401:Azygos Vein / Q000293:injuries*; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D022125:Lacerations / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D013898:Thoracic Injuries / Q000453:epidemiology / Q000209:etiology; D015599:Trauma Severity Indices; D014949:Wounds, Nonpenetrating / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
references.citation: Scand J Trauma Resusc Emerg Med. 2009 Sep 14;17 :42
references.pmid: 19751511
references.citation: J Trauma. 2000 Oct;49(4):776-9
references.pmid: 11038104
references.citation: Chin Med J (Engl). 2012 Sep;125(18):3355-6
references.pmid: 22964338
references.citation: Interact Cardiovasc Thorac Surg. 2010 Sep;11(3):342-4
references.pmid: 20576652
references.citation: J Trauma. 2006 Feb;60(2):357-62
references.pmid: 16508496
references.citation: J Trauma. 1999 Jan;46(1):192-5
references.pmid: 9932707
references.citation: Eur J Vasc Endovasc Surg. 2012 Aug;44(2):203-9
references.pmid: 22658774
references.citation: J Trauma. 1995 Oct;39(4):761-2
references.pmid: 7473972
references.citation: J Trauma. 2006 Aug;61(2):444-6
references.pmid: 16917464
references.citation: Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2007 Dec;151(2):347-8
references.pmid: 18345276
references.citation: Injury. 1998 Jun;29(5):380-2
references.pmid: 9813684