Early Palma procedure after iliac vein injury in abdominal penetrating trauma

Journal of Vascular Surgery
Francisco AlcocerWilliam D Jordan

Abstract

Ligation for penetrating abdominal vein trauma may have better outcome than a vascular reconstruction in an unstable patient. However, symptoms of chronic venous insufficiency may appear over time. We describe our surgical experience with 4 patients who underwent iliac vein ligation followed by venous bypass with a modified Palma derivation between 48 and 240 hours after sustaining penetrating abdominal trauma with concomitant iliac vein injury. Patients were assessed for venous symptoms and conduit patency with continuous wave Doppler and duplex scanning. One graft occluded acutely and the remaining three remain patent with functioning valves. In order to preserve venous outflow after severe iliac vein injury, we think that venous ligation as a part of damage control surgery followed by a modified Palma operation may prevent chronic symptoms of venous outflow obstruction without compromising an already injured patient.

References

Oct 1, 1992·The Journal of Trauma·J A Yelon, T M Scalea
Dec 1, 1986·Journal of Vascular Surgery·G A TimberlakeM D Kerstein
Sep 1, 1980·The Journal of Trauma·R J MullinsA M Ledgerwood
Feb 1, 1997·Journal of Vascular Surgery·P J PappasR W Hobson
Sep 25, 1997·Archives of Surgery·K M BermudezC L Dean
Jun 24, 1998·The Journal of Trauma·E H CarrilloJ D Richardson
Dec 7, 2002·Journal of Vascular Surgery·Erkan KuralayHarun Tatar
Nov 12, 2003·Archives of Surgery·Juan A AsensioThomas V Berne

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Citations

May 6, 2015·Journal of Cranio-maxillo-facial Surgery : Official Publication of the European Association for Cranio-Maxillo-Facial Surgery·T FretwurstK Nelson
Jul 9, 2016·Hernia : the Journal of Hernias and Abdominal Wall Surgery·R R OssendorpJ Vermeulen

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