Citation Information :
Mansilla S, Pouy A, Brito N, Zubiaurre V, Cubas S, Muniz N, Machado F. Nonoperative Management of Retrohepatic Vena Cava Penetrating Trauma. Panam J Trauma Crit Care Emerg Surg 2023; 12 (1):25-29.
Background: Despite advances in trauma care, injuries to the inferior vena cava (IVC) continue to have a high mortality rate, up to 75%. An exceptional proportion of patients can be considered for nonoperative management (NOM). They require specific therapeutic management and represent a challenge for the surgical team.
Objective: A case report of a 33-year-old patient with penetrating retrohepatic vena cava trauma with successful NOM and literature review is presented.
Design and methodology: Bibliographic review was carried out in the PubMed, Cochrane library, Scielo, and Latin American and Caribbean Health Sciences Literature (LILACS) databases.
Results: The absolute conditions for NOM of penetrating retrohepatic vena cava trauma are: hemodynamic stability, absence of peritoneal irritation and admission to an intensive care unit with computed tomography (CT) and surgical block available 24 hours. Main questions arise regarding the opportunity for imaging control, absolute rest indication, and thromboprophylaxis.
Conclusion: Retrohepatic vena cava injury is associated with fatal outcomes. In a selected group of patients, NOM is a valid therapeutic option. Close monitoring and follow-ups are necessary.
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