Retrohepaticus vena cava sérülés két sikeresen operált esete.

Translated title of the contribution: [Successful treatment of retrohepatic inferior vena cava injury: report of two cases].

Károly Gábor Szabó, Adrienn Csiszkó, László Sasi-Szabó, Sándor Bányai, Zoltán Szentkereszty, Zsigmond Varga, Károly Fekete, P. Sápy, László Damjanovich, Zsolt Szentkereszty

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Authors present two cases of successfully operated patients with retrohepatic inferior vena cava (IVC) injury. In the first case a 79 year old female patient suffered from multiple stab wounds in the area of the 4th segment of the right lung as well as in the retrohepatic region in close proximity to the IVC. At the time of the first surgery the IVC injury was not identified. During a second operation, however, the IVC was isolated from the liver using an anterior dissection of the parenchyma with finger-fracture technique and the injury was oversawn finally. Successful haemostasis of the liver was achieved by packing of the perihepatic space, which was removed three days later. In the second case a 25 year-old male patient had suffered blunt abdominal trauma. He underwent laparotomy and packing on the site of the hepatic injury, which had to be repeated seven more times. Later on, another urgent laparotomy was carried out for recurring intraabdominal bleeding and bile leakage, and cholecystectomy was performed due to gallbladder perforation. Another two days later a further emergency laparotomy was indicated for ongoing intraabdominal bleeding, when the bleeding source - an injury (3 mm in diameter) of the retrohepatic IVC - was oversawn. After relatively long postoperative stay both patients were fully recovered and discharged from hospital. CONCLUSIONS: penetrating injuries of the IVC are associated with high mortality rate of approximately 78%. Proper management of these injuries requires experience in both vascular and liver surgery. Retrohepatic IVC injury needs to be considered in the differential diagnosis of ongoing bleeding in penetrating or blunt liver trauma. Packing of the liver is a reliable haemostatic method if bleeding persists due to division of the liver parenchyma.

Original languageHungarian
Pages (from-to)242-245
Number of pages4
JournalMagyar sebészet
Volume64
Issue number5
Publication statusPublished - Oct 2011

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Inferior Vena Cava
Wounds and Injuries
Liver
Hemorrhage
Laparotomy
Therapeutics
Multiple Trauma
Cholecystectomy
Hemostatics
Gallbladder
Hemostasis
Bile
Fingers
Blood Vessels
Dissection
Emergencies
Differential Diagnosis
Lung
Mortality

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Szabó, K. G., Csiszkó, A., Sasi-Szabó, L., Bányai, S., Szentkereszty, Z., Varga, Z., ... Szentkereszty, Z. (2011). Retrohepaticus vena cava sérülés két sikeresen operált esete. Magyar sebészet, 64(5), 242-245.

Retrohepaticus vena cava sérülés két sikeresen operált esete. / Szabó, Károly Gábor; Csiszkó, Adrienn; Sasi-Szabó, László; Bányai, Sándor; Szentkereszty, Zoltán; Varga, Zsigmond; Fekete, Károly; Sápy, P.; Damjanovich, László; Szentkereszty, Zsolt.

In: Magyar sebészet, Vol. 64, No. 5, 10.2011, p. 242-245.

Research output: Contribution to journalArticle

Szabó, KG, Csiszkó, A, Sasi-Szabó, L, Bányai, S, Szentkereszty, Z, Varga, Z, Fekete, K, Sápy, P, Damjanovich, L & Szentkereszty, Z 2011, 'Retrohepaticus vena cava sérülés két sikeresen operált esete.', Magyar sebészet, vol. 64, no. 5, pp. 242-245.
Szabó KG, Csiszkó A, Sasi-Szabó L, Bányai S, Szentkereszty Z, Varga Z et al. Retrohepaticus vena cava sérülés két sikeresen operált esete. Magyar sebészet. 2011 Oct;64(5):242-245.
Szabó, Károly Gábor ; Csiszkó, Adrienn ; Sasi-Szabó, László ; Bányai, Sándor ; Szentkereszty, Zoltán ; Varga, Zsigmond ; Fekete, Károly ; Sápy, P. ; Damjanovich, László ; Szentkereszty, Zsolt. / Retrohepaticus vena cava sérülés két sikeresen operált esete. In: Magyar sebészet. 2011 ; Vol. 64, No. 5. pp. 242-245.
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abstract = "Authors present two cases of successfully operated patients with retrohepatic inferior vena cava (IVC) injury. In the first case a 79 year old female patient suffered from multiple stab wounds in the area of the 4th segment of the right lung as well as in the retrohepatic region in close proximity to the IVC. At the time of the first surgery the IVC injury was not identified. During a second operation, however, the IVC was isolated from the liver using an anterior dissection of the parenchyma with finger-fracture technique and the injury was oversawn finally. Successful haemostasis of the liver was achieved by packing of the perihepatic space, which was removed three days later. In the second case a 25 year-old male patient had suffered blunt abdominal trauma. He underwent laparotomy and packing on the site of the hepatic injury, which had to be repeated seven more times. Later on, another urgent laparotomy was carried out for recurring intraabdominal bleeding and bile leakage, and cholecystectomy was performed due to gallbladder perforation. Another two days later a further emergency laparotomy was indicated for ongoing intraabdominal bleeding, when the bleeding source - an injury (3 mm in diameter) of the retrohepatic IVC - was oversawn. After relatively long postoperative stay both patients were fully recovered and discharged from hospital. CONCLUSIONS: penetrating injuries of the IVC are associated with high mortality rate of approximately 78{\%}. Proper management of these injuries requires experience in both vascular and liver surgery. Retrohepatic IVC injury needs to be considered in the differential diagnosis of ongoing bleeding in penetrating or blunt liver trauma. Packing of the liver is a reliable haemostatic method if bleeding persists due to division of the liver parenchyma.",
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AU - Bányai, Sándor

AU - Szentkereszty, Zoltán

AU - Varga, Zsigmond

AU - Fekete, Károly

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