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2016 ; 1
(1
): e000015
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Abdominal vascular trauma
#MMPMID29766059
Kobayashi LM
; Costantini TW
; Hamel MG
; Dierksheide JE
; Coimbra R
Trauma Surg Acute Care Open
2016[]; 1
(1
): e000015
PMID29766059
show ga
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.