PDF(Pubmed)
Abstract：
BACKGROUND Inferior vena cava (IVC) injury is a potentially fatal injury with a high mortality rate of 34-70%. In cases in which the patient\'s condition is stable, diagnosis by computed tomography (CT) is the criterion standard. Findings on CT include retroperitoneal hematoma around the IVC, extravasation of contrast medium, and abnormal morphology of the IVC. We report a case of an IVC injury that could not be diagnosed by preoperative CT examination and could not be immediately detected during laparotomy. CASE REPORT A 73-year-old woman had stabbed herself in the neck and abdomen at home using a knife. When she arrived at our hospital, we found a stab wound several centimeters long on her abdomen and a cut approximately 15 cm long on her neck. We activated the massive transfusion protocol because she was in a condition of hemorrhagic shock. After blood transfusion and blood pressure stabilization, contrast-enhanced computed tomography (CT) revealed a small amount of fluid in the abdominal cavity. An otorhinolaryngologist performed successful drainage and hemostasis, and a laparotomy was performed. Gastric injury and mesentery injury of the transverse colon were identified and repaired with sutures. Subsequent search of the retroperitoneum revealed massive bleeding from an injury to the inferior vena cava (IVC). The IVC was repaired. Postoperative progress was good, and she was discharged from the hospital 65 days after her injuries. CONCLUSIONS We experienced a case of penetrating IVC injury, which is a rare trauma. Occult IVC injury may escape detection by preoperative CT examination or during laparotomy.
摘要：
背景技术下腔静脉(IVC)损伤是具有34-70%的高死亡率的潜在致命性损伤。在患者病情稳定的情况下，计算机断层扫描（CT）诊断是标准。CT表现包括IVC周围腹膜后血肿，造影剂外渗,IVC形态异常。我们报告了一例IVC损伤，在术前CT检查中无法诊断，并且在剖腹手术中无法立即检测到。案例报告一名73岁的妇女在家中用刀刺伤了自己的脖子和腹部。当她到达我们医院时，我们在她的腹部发现了几厘米长的刺伤，在她的脖子上发现了大约15厘米长的伤口。我们启动了大量输血方案，因为她处于出血性休克状态。输血后血压稳定,对比增强计算机断层扫描（CT）显示腹腔中有少量液体。一位耳鼻喉科医生成功进行了引流和止血，并进行了剖腹手术。确定横结肠的胃损伤和肠系膜损伤并用缝线修复。随后对腹膜后的搜索显示，下腔静脉（IVC）受伤导致大量出血。IVC已修复。术后进展良好,她受伤65天后出院。结论我们经历了一例穿透性IVC损伤，这是一种罕见的创伤。隐匿性IVC损伤可能无法通过术前CT检查或剖腹手术发现。
