Inferior Vena Kava, Portal ve Mezenterik Venöz Sistem Yaralanmaları
Özet
Inferior vena kava (IVK), portal ven (PV) ve superior mezenterik ven (SMV) yaralanmalarının klinik yönetimi hayatidir. Bu yaralanmalar, yüksek mortalite oranları ve karmaşık anatomik lokalizasyonları nedeniyle ciddi cerrahi zorluklar yaratmaktadır. Hemodinamik stabilitenin sağlanmasının önemlidir, travmatik venöz hasarların tanısında ve tedavisinde kullanılan ileri görüntüleme teknikleri, cerrahi eksplorasyon yöntemleri ve vasküler onarım stratejileri detaylı şekilde bahsedilmiştir. Primer tamir, patch-plasty, endovasküler girişimler ve şant uygulamaları gibi tekniklerin kullanımı değerlendirilmektedir. Ayrıca, mevcut literatüre dayanarak mortalite ve morbidite oranlarının azaltılmasına yönelik öneriler sunulmaktadır.
The clinical management of inferior vena cava (IVC), portal vein (PV), and superior mesenteric vein (SMV) injuries is crucial. These injuries pose significant surgical challenges due to high mortality rates and complex anatomical localization. The importance of achieving hemodynamic stability is emphasized, with detailed discussions on advanced imaging modalities, surgical exploration techniques, and vascular repair strategies for the diagnosis and treatment of traumatic venous injuries. Techniques such as primary repair, patch-plasty, endovascular interventions, and shunt applications are evaluated. Additionally, recommendations for reducing mortality and morbidity rates are provided based on the existing literature.
Referanslar
Coimbra R, Filho AR, Nesser RA, Rasslan S. Outcome from traumatic injury of the portal and superior mesenteric veins. Vasc Endovascular Surg. 2004;38(3):249-55.
Asensio JA, Forno W, Roldán G, Petrone P, Rojo E, Ceballos J, et al. Visceral vascular injuries. Surg Clin North Am. 2002;82(1):1-20, xix.
Pearl J, Chao A, Kennedy S, Paul B, Rhee P. Traumatic injuries to the portal vein: case study. J Trauma. 2004;56(4):779-82.
Duncan IC, Sher BJ, Fingleson LM. Blunt injury of the infrarenal inferior vena cava--imaging and conservative management. S Afr J Surg. 2005;43(1):20-1.
Bui TD, Mills JL. Control of inferior vena cava injury using percutaneous balloon catheter occlusion. Vasc Endovascular Surg. 2009;43(5):490-3.
Debakey ME, Simeone FA. Battle Injuries of the Arteries in World War II : An Analysis of 2,471 Cases. Ann Surg. 1946;123(4):534-79.
Sullivan PS, Dente CJ, Patel S, Carmichael M, Srinivasan JK, Wyrzykowski AD, et al. Outcome of ligation of the inferior vena cava in the modern era. Am J Surg. 2010;199(4):500-6.
Feliciano DV, Bitondo CG, Mattox KL, Burch JM, Jordan GL, Jr., Beall AC, Jr., et al. Civilian trauma in the 1980s. A 1-year experience with 456 vascular and cardiac injuries. Ann Surg. 1984;199(6):717-24.
Mattox KL, Feliciano DV, Burch J, Beall AC, Jr., Jordan GL, Jr., De Bakey ME. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg. 1989;209(6):698-705; discussion 6-7.
Asensio JA, Chahwan S, Hanpeter D, Demetriades D, Forno W, Gambaro E, et al. Operative management and outcome of 302 abdominal vascular injuries. Am J Surg. 2000;180(6):528-33; discussion 33-4.
Rasmussen TE, Tai NRM. Rich’s Vascular Trauma E-Book: Elsevier Health Sciences; 2015.
Matsumoto S, Sekine K, Yamazaki M, Sasao K, Funabiki T, Shimizu M, et al. Predictive value of a flat inferior vena cava on initial computed tomography for hemodynamic deterioration in patients with blunt torso trauma. J Trauma. 2010;69(6):1398-402.
Timberlake GA, O'Connell RC, Kerstein MD. Venous injury: to repair or ligate, the dilemma. J Vasc Surg. 1986;4(6):553-8.
Huerta S, Bui TD, Nguyen TH, Banimahd FN, Porral D, Dolich MO. Predictors of mortality and management of patients with traumatic inferior vena cava injuries. Am Surg. 2006;72(4):290-6.
Li SJ, Lee J, Hall J, Sutherland TR. The inferior vena cava: anatomical variants and acquired pathologies. Insights into Imaging. 2021;12(1):123.
Giannakopoulos TG, Avgerinos ED. Management of Peripheral and Truncal Venous Injuries. Front Surg. 2017;4:46.
Buckman RF, Jr., Miraliakbari R, Badellino MM. Juxtahepatic venous injuries: a critical review of reported management strategies. J Trauma. 2000;48(5):978-84.
Bouabdallaoui N, Debbagh H, Schoell T, Lebreton G. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma. Ann Thorac Surg. 2016;101(5):1972-4.
Hommes M, Kazemier G, van Dijk LC, Kuipers EJ, van Ijsseldijk A, Vogels LM, et al. Complex liver trauma with bilhemia treated with perihepatic packing and endovascular stent in the vena cava. J Trauma. 2009;67(2):E51-3.
Denton JR, Moore EE, Coldwell DM. Multimodality treatment for grade V hepatic injuries: perihepatic packing, arterial embolization, and venous stenting. J Trauma. 1997;42(5):964-7; discussion 7-8.
Castelli P, Caronno R, Piffaretti G, Tozzi M. Emergency endovascular repair for traumatic injury of the inferior vena cava. Eur J Cardiothorac Surg. 2005;28(6):906-8.
Sam AD, 2nd, Frusha JD, McNeil JW, Olinde AJ. Repair of a blunt traumatic inferior vena cava laceration with commercially available endografts. J Vasc Surg. 2006;43(4):841-3.
Chandhok P, Civil ID. Intraabdominal Vascular Injuries in Blunt Trauma: Spectrum of Presentation, Severity and Management Options. Current Trauma Reports. 2017;3(1):51-61.
Kobayashi L, Coimbra R, Goes AMO, Jr., Reva V, Santorelli J, Moore EE, et al. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of abdominal vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1197-211.
Carr JA, Kralovich KA, Patton JH, Horst HM. Primary venorrhaphy for traumatic inferior vena cava injuries. Am Surg. 2001;67(3):207-13; discussion 13-4.
Macho JR, Markison RE, Schecter WP. Cardiac stapling in the management of penetrating injuries of the heart: rapid control of hemorrhage and decreased risk of personal contamination. J Trauma. 1993;34(5):711-5; discussion 5-6.
Donahue TK, Strauch GO. Ligation as definitive management of injury to the superior mesenteric vein. J Trauma. 1988;28(4):541-3.
Fraga GP, Bansal V, Fortlage D, Coimbra R. A 20-year experience with portal and superior mesenteric venous injuries: has anything changed? Eur J Vasc Endovasc Surg. 2009;37(1):87-91.
Jurkovich GJ, Hoyt DB, Moore FA, Ney AL, Morris JA, Jr., Scalea TM, et al. Portal triad injuries. J Trauma. 1995;39(3):426-34.
Ierardi AM, Berselli M, Cuffari S, Castelli P, Cocozza E, Carrafiello G. Uncommon Case of a Post-Traumatic Portal Vein Pseudoaneurysm Treated with Percutaneous Transhepatic Stent Grafting. Cardiovasc Intervent Radiol. 2016;39(10):1506-9.
Avery LE, Stahlfeld KR, Corcos AC, Scifres AM, Ziembicki JA, Varcelotti J, et al. Evolving role of endovascular techniques for traumatic vascular injury: a changing landscape? J Trauma Acute Care Surg. 2012;72(1):41-6; discussion 6-7.
Emmiler M, Kocogullari CU, Yilmaz S, Cekirdekci A. Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report. Vasc Endovascular Surg. 2008;42(3):272-5.
Stone HH, Fabian TC, Turkleson ML. Wounds of the portal venous system. World J Surg. 1982;6(3):335-41.
English WP, Johnson MB, Borman KR, Turner WW, Jr. Mesenteric ischemia: an unusual presentation of traumatic intrahepatic arterioportal fistula. Am Surg. 2001;67(9):865-7.
Asensio JA, Berne JD, Chahwan S, Hanpeter D, Demetriades D, Marengo J, et al. Traumatic injury to the superior mesenteric artery. Am J Surg. 1999;178(3):235-9.
Petersen SR, Sheldon GF, Lim RC, Jr. Management of portal vein injuries. J Trauma. 1979;19(8):616-20.
Asensio JA, Petrone P, Garcia-Nuñez L, Healy M, Martin M, Kuncir E. Superior mesenteric venous injuries: to ligate or to repair remains the question. J Trauma. 2007;62(3):668-75; discussion 75.
Schrock T, Blaisdell FW, Mathewson C, Jr. Management of blunt trauma to the liver and hepatic veins. Arch Surg. 1968;96(5):698-704.
Burch JM, Feliciano DV, Mattox KL. The atriocaval shunt. Facts and fiction. Ann Surg. 1988;207(5):555-68.
Granchi T, Schmittling Z, Vasquez J, Schreiber M, Wall M. Prolonged use of intraluminal arterial shunts without systemic anticoagulation. Am J Surg. 2000;180(6):493-6; discussion 6-7.
Marino IR, di Francesco F, Doria C, Gruttadauria S, Lauro A, Scott VL. A new technique for successful management of a complete suprahepatic caval transection. J Am Coll Surg. 2008;206(1):190-4.
Liao GP, Braslow B, Schwab CW, Woo YJ. Cavopulmonary bypass to facilitate infrahepatic vena cava gunshot wound repair. Ann Thorac Surg. 2010;89(6):2026-8.
Referanslar
Coimbra R, Filho AR, Nesser RA, Rasslan S. Outcome from traumatic injury of the portal and superior mesenteric veins. Vasc Endovascular Surg. 2004;38(3):249-55.
Asensio JA, Forno W, Roldán G, Petrone P, Rojo E, Ceballos J, et al. Visceral vascular injuries. Surg Clin North Am. 2002;82(1):1-20, xix.
Pearl J, Chao A, Kennedy S, Paul B, Rhee P. Traumatic injuries to the portal vein: case study. J Trauma. 2004;56(4):779-82.
Duncan IC, Sher BJ, Fingleson LM. Blunt injury of the infrarenal inferior vena cava--imaging and conservative management. S Afr J Surg. 2005;43(1):20-1.
Bui TD, Mills JL. Control of inferior vena cava injury using percutaneous balloon catheter occlusion. Vasc Endovascular Surg. 2009;43(5):490-3.
Debakey ME, Simeone FA. Battle Injuries of the Arteries in World War II : An Analysis of 2,471 Cases. Ann Surg. 1946;123(4):534-79.
Sullivan PS, Dente CJ, Patel S, Carmichael M, Srinivasan JK, Wyrzykowski AD, et al. Outcome of ligation of the inferior vena cava in the modern era. Am J Surg. 2010;199(4):500-6.
Feliciano DV, Bitondo CG, Mattox KL, Burch JM, Jordan GL, Jr., Beall AC, Jr., et al. Civilian trauma in the 1980s. A 1-year experience with 456 vascular and cardiac injuries. Ann Surg. 1984;199(6):717-24.
Mattox KL, Feliciano DV, Burch J, Beall AC, Jr., Jordan GL, Jr., De Bakey ME. Five thousand seven hundred sixty cardiovascular injuries in 4459 patients. Epidemiologic evolution 1958 to 1987. Ann Surg. 1989;209(6):698-705; discussion 6-7.
Asensio JA, Chahwan S, Hanpeter D, Demetriades D, Forno W, Gambaro E, et al. Operative management and outcome of 302 abdominal vascular injuries. Am J Surg. 2000;180(6):528-33; discussion 33-4.
Rasmussen TE, Tai NRM. Rich’s Vascular Trauma E-Book: Elsevier Health Sciences; 2015.
Matsumoto S, Sekine K, Yamazaki M, Sasao K, Funabiki T, Shimizu M, et al. Predictive value of a flat inferior vena cava on initial computed tomography for hemodynamic deterioration in patients with blunt torso trauma. J Trauma. 2010;69(6):1398-402.
Timberlake GA, O'Connell RC, Kerstein MD. Venous injury: to repair or ligate, the dilemma. J Vasc Surg. 1986;4(6):553-8.
Huerta S, Bui TD, Nguyen TH, Banimahd FN, Porral D, Dolich MO. Predictors of mortality and management of patients with traumatic inferior vena cava injuries. Am Surg. 2006;72(4):290-6.
Li SJ, Lee J, Hall J, Sutherland TR. The inferior vena cava: anatomical variants and acquired pathologies. Insights into Imaging. 2021;12(1):123.
Giannakopoulos TG, Avgerinos ED. Management of Peripheral and Truncal Venous Injuries. Front Surg. 2017;4:46.
Buckman RF, Jr., Miraliakbari R, Badellino MM. Juxtahepatic venous injuries: a critical review of reported management strategies. J Trauma. 2000;48(5):978-84.
Bouabdallaoui N, Debbagh H, Schoell T, Lebreton G. Surgical Management of Undiagnosed Laceration of Superior Vena Cava Caused by Blunt Trauma. Ann Thorac Surg. 2016;101(5):1972-4.
Hommes M, Kazemier G, van Dijk LC, Kuipers EJ, van Ijsseldijk A, Vogels LM, et al. Complex liver trauma with bilhemia treated with perihepatic packing and endovascular stent in the vena cava. J Trauma. 2009;67(2):E51-3.
Denton JR, Moore EE, Coldwell DM. Multimodality treatment for grade V hepatic injuries: perihepatic packing, arterial embolization, and venous stenting. J Trauma. 1997;42(5):964-7; discussion 7-8.
Castelli P, Caronno R, Piffaretti G, Tozzi M. Emergency endovascular repair for traumatic injury of the inferior vena cava. Eur J Cardiothorac Surg. 2005;28(6):906-8.
Sam AD, 2nd, Frusha JD, McNeil JW, Olinde AJ. Repair of a blunt traumatic inferior vena cava laceration with commercially available endografts. J Vasc Surg. 2006;43(4):841-3.
Chandhok P, Civil ID. Intraabdominal Vascular Injuries in Blunt Trauma: Spectrum of Presentation, Severity and Management Options. Current Trauma Reports. 2017;3(1):51-61.
Kobayashi L, Coimbra R, Goes AMO, Jr., Reva V, Santorelli J, Moore EE, et al. American Association for the Surgery of Trauma-World Society of Emergency Surgery guidelines on diagnosis and management of abdominal vascular injuries. J Trauma Acute Care Surg. 2020;89(6):1197-211.
Carr JA, Kralovich KA, Patton JH, Horst HM. Primary venorrhaphy for traumatic inferior vena cava injuries. Am Surg. 2001;67(3):207-13; discussion 13-4.
Macho JR, Markison RE, Schecter WP. Cardiac stapling in the management of penetrating injuries of the heart: rapid control of hemorrhage and decreased risk of personal contamination. J Trauma. 1993;34(5):711-5; discussion 5-6.
Donahue TK, Strauch GO. Ligation as definitive management of injury to the superior mesenteric vein. J Trauma. 1988;28(4):541-3.
Fraga GP, Bansal V, Fortlage D, Coimbra R. A 20-year experience with portal and superior mesenteric venous injuries: has anything changed? Eur J Vasc Endovasc Surg. 2009;37(1):87-91.
Jurkovich GJ, Hoyt DB, Moore FA, Ney AL, Morris JA, Jr., Scalea TM, et al. Portal triad injuries. J Trauma. 1995;39(3):426-34.
Ierardi AM, Berselli M, Cuffari S, Castelli P, Cocozza E, Carrafiello G. Uncommon Case of a Post-Traumatic Portal Vein Pseudoaneurysm Treated with Percutaneous Transhepatic Stent Grafting. Cardiovasc Intervent Radiol. 2016;39(10):1506-9.
Avery LE, Stahlfeld KR, Corcos AC, Scifres AM, Ziembicki JA, Varcelotti J, et al. Evolving role of endovascular techniques for traumatic vascular injury: a changing landscape? J Trauma Acute Care Surg. 2012;72(1):41-6; discussion 6-7.
Emmiler M, Kocogullari CU, Yilmaz S, Cekirdekci A. Repair of the inferior vena cava with autogenous peritoneo-fascial patch graft following abdominal trauma: a case report. Vasc Endovascular Surg. 2008;42(3):272-5.
Stone HH, Fabian TC, Turkleson ML. Wounds of the portal venous system. World J Surg. 1982;6(3):335-41.
English WP, Johnson MB, Borman KR, Turner WW, Jr. Mesenteric ischemia: an unusual presentation of traumatic intrahepatic arterioportal fistula. Am Surg. 2001;67(9):865-7.
Asensio JA, Berne JD, Chahwan S, Hanpeter D, Demetriades D, Marengo J, et al. Traumatic injury to the superior mesenteric artery. Am J Surg. 1999;178(3):235-9.
Petersen SR, Sheldon GF, Lim RC, Jr. Management of portal vein injuries. J Trauma. 1979;19(8):616-20.
Asensio JA, Petrone P, Garcia-Nuñez L, Healy M, Martin M, Kuncir E. Superior mesenteric venous injuries: to ligate or to repair remains the question. J Trauma. 2007;62(3):668-75; discussion 75.
Schrock T, Blaisdell FW, Mathewson C, Jr. Management of blunt trauma to the liver and hepatic veins. Arch Surg. 1968;96(5):698-704.
Burch JM, Feliciano DV, Mattox KL. The atriocaval shunt. Facts and fiction. Ann Surg. 1988;207(5):555-68.
Granchi T, Schmittling Z, Vasquez J, Schreiber M, Wall M. Prolonged use of intraluminal arterial shunts without systemic anticoagulation. Am J Surg. 2000;180(6):493-6; discussion 6-7.
Marino IR, di Francesco F, Doria C, Gruttadauria S, Lauro A, Scott VL. A new technique for successful management of a complete suprahepatic caval transection. J Am Coll Surg. 2008;206(1):190-4.
Liao GP, Braslow B, Schwab CW, Woo YJ. Cavopulmonary bypass to facilitate infrahepatic vena cava gunshot wound repair. Ann Thorac Surg. 2010;89(6):2026-8.
