Abdominal vascular trauma

Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding a...

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Bibliographic Details
Published in:Trauma surgery & acute care open 2016-07, Vol.1 (1), p.e000015-e000015
Main Authors: Kobayashi, Leslie M, Costantini, Todd W, Hamel, Michelle G, Dierksheide, Julie E, Coimbra, Raul
Format: Article
Language:English
Subjects:
Abdomen
Blood
Catheters
Connective tissue
Coronary vessels
Diaphragm (Anatomy)
Dissection
Esophagus
Hematoma
Injuries
Kidneys
Ligaments
Liver
Mortality
Ostomy
Review
Spleen
Surgeons
Trauma
Veins & arteries
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Summary:Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding and advanced American Association for the Surgery of Trauma Organ Injury Scale grade. These patients often arrive at medical centers in extremis and require rapid surgical control of bleeding and aggressive resuscitation including massive transfusion protocols. The most important factor in survival is surgical control of hemorrhage and restoration of appropriate perfusion to the abdominal contents and lower extremities. These surgical approaches and the techniques of definitive vascular repair can be quite challenging, particularly to the inexperienced surgeon. This review hopes to describe the most common abdominal vascular injuries, their presentation, outcomes, and surgical techniques to control and repair such injuries.
ISSN:2397-5776
2397-5776
DOI:10.1136/tsaco-2016-000015