Management of penetrating abdominal vessel injuries

Journal of Visceral Surgery
X ChapellierB Baranger

Abstract

Vascular injury due to penetrating abdominal trauma is a major challenge for trauma teams. Arterial and venous injuries occur with equal frequency. Treatment depends on the hemodynamic status of the patient: under stable conditions, angiography can be envisioned, whereas instability is an indication for immediate surgery; damage control is the most frequent procedure. As persisting on complete surgical exploration may lead to fatal outcome, the surgeon must be prepared to perform perihepatic or pelvic packing and employ endovascular techniques as appropriate. However, the surgeon has to be prepared to deal with uncontrolled hemorrhage, and explore all central retroperitoneal hematomas, retroperitoneal hematoma located in the flanks except when stable in the hemodynamically unstable patient, and those in the pelvis only if the patient is stable. Since it is more critical to control hemorrhage than to avoid end-organ ischemia, vascular ligation is more commonly used than other techniques. However, survival is very low in these severely wounded patients.

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Citations

Feb 14, 2013·Annales Françaises D'anesthèsie Et De Rèanimation·C HoffmannB Debien
Jul 24, 2012·Journal of Visceral Surgery·C ArvieuxJ Tonetti
May 28, 2015·Emergency Radiology·David DreizinFelipe Munera
Oct 27, 2015·World Journal of Emergency Surgery : WJES·Bruno Monteiro T PereiraGustavo Pereira Fraga
Oct 23, 2015·Radiology·David Dreizin, Felipe Munera
Oct 4, 2020·The Journal of Trauma and Acute Care Surgery·Leslie KobayashiFederico Coccolini
Sep 18, 2021·Vascular and Endovascular Surgery·Patrick D MelmerJason D Sciarretta

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