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Mesenteric Vascular Injuries

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Book cover Clinical Review of Vascular Trauma

Abstract

Abdominal vascular injuries are associated with high morbidity and mortality, with patients usually presenting in shock. Surgeons caring for trauma patients need to be knowledgeable in techniques to access major vascular structures within the abdomen. Important basic principles of vascular surgery such as gaining proximal and distal control of the injured vessel, repairing vessels without significant narrowing of the vessel lumen, and when to consider patch angioplasty versus interposition grafting are crucial in dealing with abdominal vascular injuries. Damage control techniques such as temporary intravascular shunting, knowledge of which vessels may be safely ligated, and temporary abdominal closure options are critically important in treating the severely injured, unstable patient.

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References

  1. Asensio JA, Forno W, Roldan G, et al. Visceral vascular injuries. Surg Clin North Am. 2002;82:1–20, xix.

    Article  PubMed  Google Scholar 

  2. Dente C, Feliciano D. Abdominal vascular injury. In: Feliciano DV, Mattox KL, Moore EE, editors. Trauma. New York: McGraw Hill; 2008. p. 737–57.

    Google Scholar 

  3. Hoyt DB, Coimbra R, Potenza BM, et al. Anatomic exposures for vascular injuries. Surg Clin North Am. 2001;81:1299–330, xii.

    Article  PubMed  CAS  Google Scholar 

  4. Stannard A, Brown K, Benson C, et al. Outcome after vascular trauma in a deployed military trauma system. Br J Surg. 2011;98:228–34.

    Article  PubMed  CAS  Google Scholar 

  5. Asensio JA, Britt LD, Borzotta A, et al. Multiinstitutional experience with the management of superior mesenteric artery injuries. J Am Coll Surg. 2001;193:354–65; discussion 365–56.

    Article  PubMed  CAS  Google Scholar 

  6. Asensio JA, Chahwan S, Hanpeter D, et al. Operative management and outcome of 302 abdominal vascular injuries. Am J Surg. 2000;180:528–33; discussion 533–4.

    Article  PubMed  CAS  Google Scholar 

  7. Asensio JA, Soto SN, Forno W, et al. Abdominal vascular injuries: the trauma surgeon’s challenge. Surg Today. 2001;31:949–57.

    Article  PubMed  CAS  Google Scholar 

  8. Coimbra R, Yang J, Hoyt DB. Injuries of the abdominal aorta and inferior vena cava in association with thoracolumbar fractures: a lethal combination. J Trauma. 1996;41:533–5.

    Article  PubMed  CAS  Google Scholar 

  9. Davis TP, Feliciano DV, Rozycki GS, et al. Results with abdominal vascular trauma in the modern era. Am Surg. 2001;67:565–70; discussion 570–1.

    PubMed  CAS  Google Scholar 

  10. Hoyt DB, Shackford SR, McGill T, et al. The impact of in-house surgeons and operating room resuscitation on outcome of traumatic injuries. Arch Surg. 1989;124:906–9; discussion 909–10.

    Article  PubMed  CAS  Google Scholar 

  11. Paul JS, Webb TP, Aprahamian C, et al. Intraabdominal vascular injury: are we getting any better? J Trauma. 2010;69:1393–7.

    Article  PubMed  Google Scholar 

  12. Tyburski JG, Wilson RF, Dente C, et al. Factors affecting mortality rates in patients with abdominal vascular injuries. J Trauma. 2001;50:1020–6.

    Article  PubMed  CAS  Google Scholar 

  13. Asensio JA, Petrone P, Kimbrell B, et al. Lessons learned in the management of thirteen celiac axis injuries. South Med J. 2005;98:462–6.

    Article  PubMed  Google Scholar 

  14. Graham JM, Mattox KL, Beall Jr AC, et al. Injuries to the visceral arteries. Surgery. 1978;84:835–9.

    PubMed  CAS  Google Scholar 

  15. Asensio JA, Berne JD, Chahwan S, et al. Traumatic injury to the superior mesenteric artery. Am J Surg. 1999;178:235–9.

    Article  PubMed  CAS  Google Scholar 

  16. Pearl J, Chao A, Kennedy S, et al. Traumatic injuries to the portal vein: case study. J Trauma. 2004;56:779–82.

    Article  PubMed  Google Scholar 

  17. Fraga GP, Bansal V, Fortlage D, et al. A 20-year experience with portal and superior mesenteric venous injuries: has anything changed? Eur J Vasc Endovasc Surg. 2009;37:87–91.

    Article  PubMed  CAS  Google Scholar 

  18. Coimbra R, Filho AR, Nesser RA, et al. Outcome from traumatic injury of the portal and superior mesenteric veins. Vasc Endovascular Surg. 2004;38:249–55.

    Article  PubMed  Google Scholar 

  19. Asensio JA, Petrone P, Garcia-Nunez L, et al. Superior mesenteric venous injuries: to ligate or to repair remains the question. J Trauma. 2007;62:668–75; discussion 675.

    Article  PubMed  Google Scholar 

  20. Jurkovich GJ, Hoyt DB, Moore FA, et al. Portal triad injuries. J Trauma. 1995;39:426–34.

    Article  PubMed  CAS  Google Scholar 

  21. Coimbra R, Hoyt D, Winchell R, et al. The ongoing challenge of retroperitoneal vascular injuries. Am J Surg. 1996;172:541–4; discussion 545.

    Article  PubMed  CAS  Google Scholar 

  22. Eachempati SR, Robb T, Ivatury RR, et al. Factors associated with mortality in patients with penetrating abdominal vascular trauma. J Surg Res. 2002;108:222–6.

    Article  PubMed  CAS  Google Scholar 

  23. Coimbra R, Prado PA, Araujo LH, et al. Factors related to mortality in inferior vena cava injuries. A 5 year experience. Int Surg. 1994;79:138–41.

    PubMed  CAS  Google Scholar 

  24. Fullen WD, Hunt J, Altemeier WA. The clinical spectrum of penetrating injury to the superior mesenteric arterial circulation. J Trauma. 1972;12:656–64.

    Article  PubMed  CAS  Google Scholar 

  25. Hansen CJ, Bernadas C, West MA, et al. Abdominal vena caval injuries: outcomes remain dismal. Surgery. 2000;128:572–8.

    Article  PubMed  CAS  Google Scholar 

  26. Rosengart MR, Smith DR, Melton SM, et al. Prognostic factors in patients with inferior vena cava injuries. Am Surg. 1999;65:849–55; discussion 855–6.

    PubMed  CAS  Google Scholar 

  27. Holcomb JB, Wade CE, Michalek JE, et al. Increased plasma and platelet to red blood cell ratios improves outcome in 466 massively transfused civilian trauma patients. Ann Surg. 2008;248:447–58.

    PubMed  Google Scholar 

  28. Taourel P, Vernhet H, Suau A, et al. Vascular emergencies in liver trauma. Eur J Radiol. 2007;64:73–82.

    Article  PubMed  CAS  Google Scholar 

  29. Vu M, Anderson SW, Shah N, et al. CT of blunt abdominal and pelvic vascular injury. Emerg Radiol. 2010;17:21–9.

    Article  PubMed  Google Scholar 

  30. Fang JF, Shih LY, Wong YC, et al. Angioembolization and laparotomy for patients with concomitant pelvic arterial hemorrhage and blunt abdominal trauma. Langenbecks Arch Surg. 2011;396:243–50.

    Article  PubMed  Google Scholar 

  31. Martin de Carpi J, Tarrado X, Varea V. Sclerosing cholangitis secondary to hepatic artery ligation after abdominal trauma. Eur J Gastroenterol Hepatol. 2005;17:987–90.

    Article  PubMed  Google Scholar 

  32. Conti S. Splenic artery ligation for trauma. An alternative to splenectomy. Am J Surg. 1980;140:444–6.

    Article  PubMed  CAS  Google Scholar 

  33. Keramidas D, Buyukunal C, Senyuz O, et al. Splenic artery ligation: a ten-year experience in the treatment of selected cases of splenic injuries in children. Jpn J Surg. 1991;21:172–7.

    Article  PubMed  CAS  Google Scholar 

  34. Reilly PM, Rotondo MF, Carpenter JP, et al. Temporary vascular continuity during damage control: intraluminal shunting for proximal superior mesenteric artery injury. J Trauma. 1995;39:757–60.

    Article  PubMed  CAS  Google Scholar 

  35. Subramanian A, Vercruysse G, Dente C, et al. A decade’s experience with temporary intravascular shunts at a civilian level I trauma center. J Trauma. 2008;65:316–24; discussion 324–6.

    Article  PubMed  Google Scholar 

  36. Asayama Y, Matsumoto S, Isoda T, et al. A case of traumatic mesenteric bleeding controlled by only transcatheter arterial embolization. Cardiovasc Intervent Radiol. 2005;28:256–8.

    Article  PubMed  Google Scholar 

  37. Hagiwara A, Takasu A. Transcatheter arterial embolization is effective for mesenteric arterial hemorrhage in trauma. Emerg Radiol. 2009;16:403–6.

    Article  PubMed  Google Scholar 

  38. Demirel S, Winter C, Rapprich B, et al. Stab injury of the superior mesenteric artery with life threatening bleeding – endovascular treatment with an unusual technique. Vasa. 2010;39(3):268–70. doi:10.1024/0301-1526/a000041.

    Google Scholar 

  39. Kakizawa H, Toyota N, Hieda M, et al. Traumatic mesenteric bleeding managed solely with transcatheter embolization. Radiat Med. 2007;25:295–8.

    Article  PubMed  Google Scholar 

  40. Stone HH, Fabian TC, Turkleson ML. Wounds of the portal venous system. World J Surg. 1982;6:335–41.

    Article  PubMed  CAS  Google Scholar 

  41. Feliciano DV. Management of traumatic retroperitoneal hematoma. Ann Surg. 1990;211:109–23.

    Article  PubMed  CAS  Google Scholar 

  42. Carr JA, Kralovich KA, Patton JH, et al. Primary venorrhaphy for traumatic inferior vena cava injuries. Am Surg. 2001;67:207–13; discussion 213–4.

    PubMed  CAS  Google Scholar 

  43. Sullivan PS, Dente CJ, Patel S, et al. Outcome of ligation of the inferior vena cava in the modern era. Am J Surg. 2010;199:500–6.

    Article  PubMed  Google Scholar 

  44. Schrock T, Blaisdell FW, Mathewson Jr C. Management of blunt trauma to the liver and hepatic veins. Arch Surg. 1968;96:698–704.

    Article  PubMed  CAS  Google Scholar 

  45. Burch JM, Feliciano DV, Mattox KL. The atriocaval shunt. Facts and fiction. Ann Surg. 1988;207:555–68.

    Article  PubMed  CAS  Google Scholar 

  46. Trunkey DD. Trauma. Accidental and intentional injuries account for more years of life lost in the U.S. than cancer and heart disease. Among the prescribed remedies are improved preventive efforts, speedier surgery and further research. Sci Am. 1983;249:28–35.

    Google Scholar 

  47. Allison ND, Anderson CM, Shah SK, et al. Outcomes of truncal vascular injuries in children. J Pediatric Surg. 2009:44:1958–1964

    Google Scholar 

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Author information

Authors and Affiliations

  1. Division of Trauma, Surgical Critical Care and Burns, Department of Surgery, University of California San Diego Health Sciences, San Diego, CA, USA

    Leslie M. Kobayashi MD, Todd W. Costantini MD & Raul Coimbra MD, PhD

Authors
  1. Leslie M. Kobayashi MD
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  2. Todd W. Costantini MD
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  3. Raul Coimbra MD, PhD
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Corresponding author

Correspondence to Raul Coimbra MD, PhD .

Editor information

Editors and Affiliations

  1. Department of Surgery MSB 5.030, Center for Translational Injury Research, Houston, Texas, USA

    Anahita Dua

  2. Department of Surgery, University of Texas-Houston Duke University School of Medicine, Houston, Texas, USA

    Sapan S. Desai

  3. Department of Surgery, University of Texas-Houston, Houston, Texas, USA

    John B. Holcomb

  4. Department of Orthopedics, University of Texas-Houston, Houston, Texas, USA

    Andrew R. Burgess

  5. Department of Surgery, John Hopkins Medical Institutions, Baltimore, Maryland, USA

    Julie Ann Freischlag

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© 2014 Springer-Verlag Berlin Heidelberg

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Kobayashi, L.M., Costantini, T.W., Coimbra, R. (2014). Mesenteric Vascular Injuries. In: Dua, A., Desai, S., Holcomb, J., Burgess, A., Freischlag, J. (eds) Clinical Review of Vascular Trauma. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-39100-2_18

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  • DOI: https://doi.org/10.1007/978-3-642-39100-2_18

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-39099-9

  • Online ISBN: 978-3-642-39100-2

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