ABDOMINAL VASCULAR INJURIES

Trauma surgeons are occasionally faced with patients with abdominal va scular injuries, Important surgical issues in the successful managemen t of these injuries require a thorough knowledge of the abdominal vasc ular anatomy and techniques of vascular repair, that surgical explorat ion be performed without delay, that the vascular injury be exposed ra pidly with control of hemorrhage upon entering the abdomen, that effor ts be made to reestablish perfusion initially to the structures at the highest risk of anoxic injury, and an understanding that it is occasi onally necessary to perform temporary procedures while the general con dition of a patient is being stabilized, with subsequent definitive ca re. The primary goal in the management of these patients should be hem orrhage control rather than maintenance of blood flow, The principles of abbreviated laparotomy with planned reoperation should be used in s ome patients with major abdominal vascular injuries, The decision to r eestablish vascular continuity at a later time should balance anticipa ted functional outcome against potential complications.