Cheaito Ali, Tillou Areti, Lewis Catherine, Cryer Henry
Department of Surgery, David Geffen School of Medicine at UCLA, United States.
Department of Surgery, David Geffen School of Medicine at UCLA, United States.
Int J Surg Case Rep. 2016;28:26-30. doi: 10.1016/j.ijscr.2016.09.003. Epub 2016 Sep 19.
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.
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.
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.
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.
钝性创伤继发下腔静脉（IVC）损伤较为罕见，在所有钝性创伤患者中发生率低于1%。文献报道的IVC损伤死亡率在34%至70%之间。由这些损伤导致的下腔静脉假性动脉瘤也是罕见的临床病症，由于随访信息有限，其自然病程尚不确定。
本病例报告描述了一名23岁女性，因创伤性IVC夹层形成假性动脉瘤。报告还详细介绍了我们的治疗方案，以及通过影像学检查观察假性动脉瘤消退情况的随访过程。
由于这些损伤罕见，尚未有针对其治疗的大型研究，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。损伤已实现局部静脉压迫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。
在所有入院患者中，IVC损伤致死率很高，死亡率在70%至90%之间。此类损伤的治疗应根据患者的血流动力学稳定性进行调整。
