Management of traumatic blunt IVC injury. (2016)

• Record Type: Journal Article
• Authors: Cheaito, Ali; Tillou, Areti; Lewis, Catherine; Cryer, Henry
• Is Part Of: International journal of surgery case reports. Volume 28(2016)
• Page Start: 26
• Page End: 30
• Publication Date: 2016
• Subjects: Accidents, traffic -- IVC/injuries -- Pseudoaneurysm -- Management; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2016.09.003
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Blunt trauma can result in rupture IVC in the setting of multiple injuries. IVC injury is rare and fatal. We report an patient survived conservative management. IVC pseudoaneurysm can result from traumatic blunt injury to IVC. Non-operative management of blunt IVC injury can be established in setting of hemodynamic stability. Follow up for pseudoaneurysm and IVC disruption is needed to ensure non expansion. Abstract: Introduction: Injuries to the inferior vena cava (IVC) secondary to blunt trauma are rare and occurs in less than 1% of all blunt trauma patients. Mortality rates for IVC injuries reported in the literature range from 34% to 70%. Inferior vena cava (IVC) pseudoaneurysms resulting from these injuries are also rare clinical entities with an uncertain natural history due to limited follow-up information. Case presentation: This case report describes a 23-year-old woman with traumatic IVC dissection resulting in pseudoaneurysms. It also details our treatment plan, with follow-up through radiographic resolution of the pseudoaneurysms. Discussion: Due to rarity of these injuries, management of these injuries has not been subjected to major studies, but several case reports and small retrospective studies have demonstrated that management can be tailored to the hemodynamic status of the patient. Stable patients whose injuries have achieved local venous tamponade have been successfully treated without surgical intervention, while unstable patients require operative management. Conclusion: Of all incoming patients, IVC injuries are highly fatal with mortality rates between 70 and 90%. Management of these injuries should be tailored based on hemodynamic stability of such patients.