TRAUMATIC INFERIOR VENA-CAVAL INJURIES

Twenty-three cases of inferior vena caval injury (1.4% of all operativ ely managed abdominal injuries) are reviewed. The caval injury present ed as free haemorrhage in 15 cases and as a retroperitoneal haematoma in eight. The site of vena caval injury was at or above the level of t he renal veins in 14 cases (61%). Successful lateral suture repair was achieved in 18 cases (78%). The overall mortality rate was 39%. Facto rs positively associated with survival were stab wound, presentation a s retroperitoneal haematoma, infrarenal injury, low Abdominal Trauma I ndex score and small peroperative blood loss. Concomitant injury to th e abdominal aorta, liver or kidney worsened the prognosis. The crucial factor in management of inferior vena caval injuries is rapid and eff ective control of bleeding, whether from the caval or associated injur ies.