Successful Treatment of Dual Juxtahepatic Inferior Vena Cava Injuries Using Formal Atriocaval Shunt: A Case Report and Review of the Literature

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Author Info

Amanda Fobare Brandon Henry Caroline Butler Deepika Koganti Ed Childs Jonathan Nguyen Kahdi Udobi Omar K. Danner Ravi Rajani Richard Sola Ronald Hoard Rondi Gelbard

Corresponding Author

Omar K. Danner
Morehouse School of Medicine, Department of Surgery, Atlanta, Georgia, USA

A B S T R A C T

Repair of penetrating retrohepatic inferior vena cava (IVC) injuries continues to challenge trauma surgeons due to difficulty in accessing the injury, hemorrhage prior to the repair, and associated high mortality rates. Complication by suprahepatic vena cava injuries portends an increased risk of an unfavorable outcome. Over time, overall survival has been relatively unchanged, and the morbidity and mortality associated with these injuries continue to be very high. First proposed by Shrock et al. in 1968, atriocaval shunt placement remains the gold standard approach for the temporary bypass of these lesions by controlling bleeding from the retrohepatic IVC to allow time for repair prior to exsanguination and death. Despite familiarity with this management strategy for decades, these injuries remain infrequent but continue to have poor survival due to their complexity. There are only rare examples of the use of this approach resulting in successful discharge from the hospital. We present a case report of survival after the successful deployment of an atriocaval shunt in a patient who sustained multiple gunshot wounds to his right thoraco-abdomen, left chest, and upper and lower extremities. He ultimately survived to discharge from the hospital. We provide a brief review of the current literature and propose future approaches to repairs of juxtahepatic IVC injuries.

Article Info

Article Type

Case Report and Review of the Literature

Publication history

Received: Tue 14, Apr 2020
Accepted: Mon 04, May 2020
Published: Wed 13, May 2020

Copyright

© 2023 Omar K. Danner. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.SCR.2020.05.05