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The role of cardiopulmonary bypass in the management of retrohepatic vena cava injury - A case report and review of the literature

Lookup NU author(s): Sandra Robinson, Colin Wilson, Professor Derek Manas

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Abstract

Injuries to the retrohepatic vena cava are extremely rare and are associated with an operative mortality of up to 50% even in high volume trauma centres. We present a patient with such an injury who underwent successful repair using cardiopulmonary bypass and deep hypothermic circulatory arrest. A 23 year old male was transferred to our unit following laparotomy with packing of the abdomen after uncontrolled haemorrhage from the retrohepatic vena cava was experienced. The patient was placed on full cardiopulmonary bypass and cooled to 20 8C before clamping of the supracoeliac aorta and inferior vena cava. This facilitated exposure of the retrohepatic cava and allowed successful primary repair of a 5 cm laceration. Other techniques to allow repair of these injuries, such as atriocaval shunts and total vascular exclusion of the liver, are associated with a high mortality. We believe the technique described in this case report is an alternative strategy that can be used successfully to manage life threatening from the retrohepatic vena cava. © 2014 The Authors.

Publication metadata

Author(s): Robinson SM, Wilson CH, Clark SC, Manas DM

Publication type: Article

Publication status: Published

Journal: Injury Extra

Year: 2014

Volume: 45

Issue: 7

Pages: 45-47

Print publication date: 01/07/2014

Online publication date: 04/04/2014

Acceptance date: 19/03/2014

Date deposited: 25/08/2017

ISSN (print): 1572-3461

Publisher: Elsevier Ltd

URL: https://doi.org/10.1016/j.injury.2014.03.013

DOI: 10.1016/j.injury.2014.03.013

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