TY - JOUR
AR - SCR-2020-5-105
TI - Successful Treatment of Dual Juxtahepatic Inferior Vena Cava Injuries Using Formal Atriocaval Shunt: A Case Report and Review of the Literature
AU - Amanda , Fobare
AU - Brandon , Henry
AU - Caroline , Butler
AU - Deepika , Koganti
AU - Ed , Childs
AU - Jonathan , Nguyen
AU - Kahdi , Udobi
AU - Omar K., Danner
AU - Ravi , Rajani
AU - Richard , Sola
AU - Ronald , Hoard
AU - Rondi , Gelbard
JO - Surgical Case Reports
PY - 2020
DA - Wed 13, May 2020
SN - 2613-5965
DO - http://dx.doi.org/10.31487/j.SCR.2020.05.05
UR - https://www.sciencerepository.org/successful-treatment-of-dual-juxtahepatic-inferior-vena-cava-injuries_SCR-2020-5-105 
KW - Atriocaval shunt, retrohepatic inferior vena cava injury, schock shunt, hemorrhagic shock
AB - 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.