Management of traumatic blunt IVC injury

Ali Cheaito; Areti Tillou; Catherine Lewis; Henry Cryer

doi:10.1016/j.ijscr.2016.09.003

Management of traumatic blunt IVC injury

Int J Surg Case Rep. 2016:28:26-30. doi: 10.1016/j.ijscr.2016.09.003. Epub 2016 Sep 19.

Authors

Ali Cheaito¹, Areti Tillou², Catherine Lewis², Henry Cryer²

Affiliations

¹ Department of Surgery, David Geffen School of Medicine at UCLA, United States. Electronic address: acheaito@mednet.ucla.edu.
² Department of Surgery, David Geffen School of Medicine at UCLA, United States.

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.

Keywords: Accidents, traffic; IVC/injuries; Management; Pseudoaneurysm.