Management of penetrating cervicomediastinal venous trauma

Objectives: to evaluate the results of management of penetrating cervicomed iastinal venous trauma. Design: retrospective study. Materials: forty-nine consecutive patients with cervical and thoracic venou s injuries treated at a tertiary hospital between 1991 and 1997. Method: patients identified from a computerised database and data extracted from case records. Results: forty-five patients were male and the mean age was 25.3 years. For ty injuries were due to stabs and 9 to gunshots. 22 patients were shocked, 25 actively bleeding and 31 were anaemic. Veins injured were internal jugul ar in 25, subclavian in 15, brachiocephalic in 6, and superior vena cava in 3. Injured veins were ligated in 25 cases and repaired by lateral suture i n 22. No complex repairs were performed. There were 8 perioperative deaths and 5 cases of transient postoperative oedema. Venous ligation was not asso ciated with increased risk of postoperative oedema. Conclusions: ligation is an acceptable form of treatment of cervicomediasti nal venous injuries in the presence of haemodynamic instability, or where c omplex methods of repair would otherwise be necessary.