Mortality and morbidity of abdominal inferior vena-caval injuries.

OBJECTIVE: To evaluate the outcome of abdominal inferior vena-caval (IVC) injuries in patients presented to Accident and Emergency Department, Lady Reading Hospital, Peshawar.

DESIGN: An observational study.

PLACE AND DURATION OF STUDY: The study was conducted at Postgraduate Medical Institute (PGMI)/Lady Reading Hospital, Peshawar, from January 1995 to January 2003.

PATIENTS AND METHODS: Case records of all patients operated within specified period for vascular trauma having injuries to the abdominal inferior vena cava. In all cases vascular trauma management was done mainly on clinical assessment in a low equipped set up. Data on age, gender, mechanism, nature and location of inferior vena-caval injuries, other vascular and non-vascular injuries were recorded.

RESULTS: There were 22 patients, 77.27% male and 22.72% female. Age ranged from 10 to 40 years with mean age of 25.09 years. Majority of injuries were caused by penetrating injury (77.27%), blunt injury in 04.54% and 18.87% were iatrogenic. Majority (95.45%) were having single laceration of inferior vena cava and 04.54% were having more than one laceration. Associated vascular injuries involved aortic 9.09%, internal iliac in 4.54% and renal vein in 4.54%. Most common associated non-vascular injury involved small intestine (72.72%) and large gut (50%).

CONCLUSION: Inferior vena-caval injuries carries high mortality rate. When associated with multiple organ injuries and retrohepatic inferior vena-caval injuries are almost fatal.