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一例膈上型下腔静脉钝性损伤保守治疗的罕见机会。

A rare opportunity for conservative treatment in a case of blunt trauma to the supradiaphragmatic inferior vena cava.

作者信息

Matthees Nicholas G, Mankin James A, Kalinkin Olga M, Richardson Randy R

机构信息

Creighton University School of Medicine, Omaha, NE, USA

Department of Trauma Surgery, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA.

出版信息

J Surg Case Rep. 2013 Nov 4;2013(11):rjt092. doi: 10.1093/jscr/rjt092.

Abstract

Injuries to the inferior vena cava (IVC) secondary to blunt trauma are rare and occur in only 1-10% of all blunt trauma patients. 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; this is similar to the management of blunt liver injuries. Stable patients whose injuries have achieved local venous tamponade have been successfully treated without surgical intervention, while unstable patients require operative management. Regardless of patient status, however, IVC injuries are highly fatal with mortality rates between 70 and 90%. This report describes the case of a patient with a blunt traumatic injury to the supradiaphragmatic IVC with development of a pseudoaneurysm who was successfully managed conservatively.

摘要

钝性创伤继发的下腔静脉(IVC)损伤较为罕见,仅占所有钝性创伤患者的1%-10%。针对这些损伤的治疗尚未有大型研究,但一些病例报告和小型回顾性研究表明,治疗可根据患者的血流动力学状态进行调整;这与钝性肝损伤的治疗类似。损伤已实现局部静脉填塞的稳定患者无需手术干预即可成功治疗,而不稳定患者则需要手术治疗。然而,无论患者状态如何,IVC损伤的死亡率都很高,在70%至90%之间。本报告描述了一名患者的病例,该患者因钝性创伤导致膈上IVC损伤并形成假性动脉瘤,最终成功接受了保守治疗。

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