RT Journal Article
SR Electronic
T1 Abdominal vascular trauma
JF Trauma Surgery & Acute Care Open
FD BMJ Publishing Group Ltd
SP e000015
DO 10.1136/tsaco-2016-000015
VO 1
IS 1
A1 Leslie M Kobayashi
A1 Todd W Costantini
A1 Michelle G Hamel
A1 Julie E Dierksheide
A1 Raul Coimbra
YR 2016
UL http://tsaco.bmj.com/content/1/1/e000015.abstract
AB Abdominal vascular trauma, primarily due to penetrating mechanisms, is uncommon. However, when it does occur, it can be quite lethal, with mortality ranging from 20% to 60%. Increased early mortality has been associated with shock, acidosis, hypothermia, coagulopathy, free intraperitoneal bleeding and advanced American Association for the Surgery of Trauma Organ Injury Scale grade. These patients often arrive at medical centers in extremis and require rapid surgical control of bleeding and aggressive resuscitation including massive transfusion protocols. The most important factor in survival is surgical control of hemorrhage and restoration of appropriate perfusion to the abdominal contents and lower extremities. These surgical approaches and the techniques of definitive vascular repair can be quite challenging, particularly to the inexperienced surgeon. This review hopes to describe the most common abdominal vascular injuries, their presentation, outcomes, and surgical techniques to control and repair such injuries.