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The treatment of penetrating wounds of the inferior vena cava

Starzl, TE and Kaupp, HA and Beheler, EM and Freeark, RJ (1962) The treatment of penetrating wounds of the inferior vena cava. Surgery, 51 (2). 195 - 204. ISSN 0039-6060

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During the last 5 years, 10 gunshot and 2 stab wounds of the inferior vena cava have been treated, with 11 survivals and 1 death. The lacerations were above the renal veins in 4 cases and below in the others. All patients had other serious visceral injuries. Treatment consisted of suture repair in 11 cases and ligation in the twelfth. Upon exploration, free intraperitoneal bleeding from the caval wound had ceased in every case. The signal finding was a retroperitoneal hematoma which was often deceptively small. Commonly, the surgeon explored the retroperitoneal space in order to treat other visceral injuries, only to be confronted with unexpected massive hemorrhage when the hematoma was entered. Difficulties in controlling the bleeding are often related to the well-developed collateral system by which different segments of the inferior vena cava are freely connected. When a hematoma is found in the vicinity of the great vessels and the retroperitoneal space is to be explored, certain precautions should be observed. These include provision for adequate exposure, procurement of blood, and adjustment of lighting. Additional help can be summoned and vascular instruments should be brought to the operating table. A large-bore needle or cut-down should be placed in an arm vein. The posterior peritoneal incision should be planned for maximum and rapid exposure, so that hemorrhage can be quickly controlled when the plane of the hematoma is entered. © 1962.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Starzl, TEtes11@pitt.eduTES11
Kaupp, HA
Beheler, EM
Freeark, RJ
Centers: Other Centers, Institutes, Offices, or Units > Thomas E. Starzl Transplantation Institute
Date: 1 February 1962
Date Type: Publication
Journal or Publication Title: Surgery
Volume: 51
Number: 2
Page Range: 195 - 204
Institution: University of Pittsburgh
Refereed: Yes
ISSN: 0039-6060
Other ID: uls-drl:31735062122845, Starzl CV No. 52
Date Deposited: 08 Apr 2010 16:59
Last Modified: 02 Feb 2019 13:57


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