Injuries to Great Vessels of the Abdomen

2016 ◽  
Author(s):  
David V. Feliciano ◽  
Juan A. Asensio
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gunshot Wound ◽  
Damage Control ◽  
Left Kidney ◽  
Vena Cava ◽  
Penetrating Trauma ◽  
Segmental Resection ◽  
Patch Repair ◽  
Great Vessels

In patients who have injuries to the great vessels of the abdomen, the findings on physical examination generally depend on whether a contained hematoma or active hemorrhage is present. This review covers resuscitation in profoundly hypotensive patients, damage control resuscitation, injuries in zones 1, 2, and 3, injuries in the porta hepatis or retrohepatic area, damage control laparatomy, endovascular therapies, and complications. Figures show algorithms illustrating management of intra-abdominal hematoma found at operation after penetrating trauma and blunt trauma; left medial visceral rotation performed by sharp and blunt dissection with elevation of the left colon, the left kidney, the spleen, the tail of the pancreas, and the gastric fundus; an autopsy view of the supraceliac aorta and the celiac axis, the proximal superior mesenteric artery, and the medially rotated left renal artery after removal of lymphatic and nerve tissue; injuries to the prepyloric area of the stomach and to the supraceliac abdominal aorta from a gunshot wound; a temporary intraluminal shunt inserted into the proximal superior mesenteric artery in a patient who had an adjacent injury to the neck of the pancreas after sustaining a gunshot wound; polytetrafluoroethylene patch repair of an injury to the infrarenal inferior vena cava; right perirenal hematoma and left external iliac artery and vein injury repaired with segmental resection and insertion of an 8 mm polytetrafluoroethylene graft and segmental resection and an end-to-end anastomosis, respectively. Tables list American Association for the Surgery of Trauma abdominal vascular organ injury scale, and survival rates after injuries to arteries and veins in the abdomen.   This review contains 9 highly rendered figures, 3 tables, and 89 references

Injuries to Great Vessels of the Abdomen

2016 ◽  
Author(s):  
David V. Feliciano ◽  
Juan A. Asensio
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Gunshot Wound ◽  
Damage Control ◽  
Left Kidney ◽  
Vena Cava ◽  
Penetrating Trauma ◽  
Segmental Resection ◽  
Patch Repair ◽  
Great Vessels

In patients who have injuries to the great vessels of the abdomen, the findings on physical examination generally depend on whether a contained hematoma or active hemorrhage is present. This review covers resuscitation in profoundly hypotensive patients, damage control resuscitation, injuries in zones 1, 2, and 3, injuries in the porta hepatis or retrohepatic area, damage control laparatomy, endovascular therapies, and complications. Figures show algorithms illustrating management of intra-abdominal hematoma found at operation after penetrating trauma and blunt trauma; left medial visceral rotation performed by sharp and blunt dissection with elevation of the left colon, the left kidney, the spleen, the tail of the pancreas, and the gastric fundus; an autopsy view of the supraceliac aorta and the celiac axis, the proximal superior mesenteric artery, and the medially rotated left renal artery after removal of lymphatic and nerve tissue; injuries to the prepyloric area of the stomach and to the supraceliac abdominal aorta from a gunshot wound; a temporary intraluminal shunt inserted into the proximal superior mesenteric artery in a patient who had an adjacent injury to the neck of the pancreas after sustaining a gunshot wound; polytetrafluoroethylene patch repair of an injury to the infrarenal inferior vena cava; right perirenal hematoma and left external iliac artery and vein injury repaired with segmental resection and insertion of an 8 mm polytetrafluoroethylene graft and segmental resection and an end-to-end anastomosis, respectively. Tables list American Association for the Surgery of Trauma abdominal vascular organ injury scale, and survival rates after injuries to arteries and veins in the abdomen. This review contains 9 highly rendered figures, 3 tables, and 89 references

scholarly journals Inverted Nutcracker Syndrome: A Case of Persistent Hematuria and Pain in the Presence of a Left-Sided Inferior Vena Cava

2011 ◽  
Vol 11 ◽  
pp. 1031-1035 ◽  
Author(s):  
Obi Ekwenna ◽  
Michael A. Gorin ◽  
Miguel Castellan ◽  
Victor Casillas ◽  
Gaetano Ciancio
Keyword(s):  
Inferior Vena Cava ◽  
Superior Mesenteric Artery ◽  
Renal Vein ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Left Renal Vein ◽  
Left Kidney ◽  
Vena Cava ◽  
Nutcracker Syndrome ◽  
The Right

Nutcracker syndrome is described as the symptomatic compression of left renal vein between the aorta and the superior mesenteric artery, resulting in outflow congestion of the left kidney. We present the case of a 51-year-old male with a left-sided inferior vena cava, resulting in compression of the right renal vein by the superior mesenteric artery. Secondary to this anatomic anomaly, the patient experienced a many-year history of flank pain and intermittent gross hematuria. We have termed this unusual anatomic finding and its associated symptoms as the “inverted nutcracker syndrome”, and describe its successful management with nephrectomy and autotransplantation.

The Distribution of Vasculokinase in Human Blood Vessels

1962 ◽  
Vol 08 (01) ◽  
pp. 096-100
Author(s):  
Marvin Murray ◽  
Robert Johnson
Keyword(s):  
Inferior Vena Cava ◽  
Superior Mesenteric Artery ◽  
Blood Vessels ◽  
Human Blood ◽  
Iliac Artery ◽  
Popliteal Artery ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
High Concentrations

Summary133 blood vessels were evaluated for vasculokinase concentration in the freshly morbid state. High concentrations of activity were found in the aorta, iliac artery, superior mesenteric artery and popliteal artery. Activity was occasionally found in the inferior vena cava and common iliacs veins. Other vessels evaluated had no activity. Evaluation of the data with respect to vas-culokinase activity and atherosclerosis suggests higher levels of vasculokinase in those vessels having atherosclerosis.

scholarly journals Superior Mesenteric Artery Syndrome with Abdominal Compartment Syndrome

2016 ◽  
Vol 2016 ◽  
pp. 1-4 ◽  
Author(s):  
Kevin Reece ◽  
Rachel Day ◽  
Janna Welch
Keyword(s):  
Superior Mesenteric Artery ◽  
Compartment Syndrome ◽  
Abdominal Compartment Syndrome ◽  
Mesenteric Artery ◽  
Inferior Vena ◽  
Vena Cava ◽  
Exploratory Laparotomy ◽  
Sensory Function ◽  
Sma Syndrome ◽  
Abdominal Compartment

Superior Mesenteric Artery (SMA) syndrome is a condition in which the duodenum becomes compressed between the SMA and the aorta, resulting in bowel obstruction which subsequently compresses surrounding structures. Pressure on the inferior vena cava (IVC) and aorta decreases cardiac output which compromises distal blood flow, resulting in abdominal compartment syndrome with ischemia and renal failure. A 15-year-old male with SMA syndrome presented with 12 hours of pain, a distended, rigid abdomen, mottled skin below the waist, and decreased motor and sensory function in the lower extremities. Exploratory laparotomy revealed ischemic small bowel and stomach with abdominal compartment syndrome. Despite decompression, the patient arrested from hyperkalemia following reperfusion.

Establishment of an Acute Superior Mesenteric Artery Injury Model for Damage Control Surgery

2009 ◽  
Vol 152 (2) ◽  
pp. 249-257 ◽  
Author(s):  
Weiwei Ding ◽  
Xingjiang Wu ◽  
Guanwen Gong ◽  
Qingxin Meng ◽  
Lideng Ni ◽  
...  
Keyword(s):  
Superior Mesenteric Artery ◽  
Mesenteric Artery ◽  
Damage Control ◽  
Damage Control Surgery ◽  
Artery Injury ◽  
Injury Model

scholarly journals SYSTEMIC VASCULITIS WITH LESION OF LARGE VESSELS AS A CAUSE OF ART ERIAL HYPERT ENSION IN A PATIENT OF YOUNG AGE

The Clinician ◽  
2018 ◽  
Vol 12 (1) ◽  
pp. 43-50
Author(s):  
D. Yu. Andriyashkina ◽  
N. A. Demidova ◽  
N. А. Shostak ◽  
D. A. Somov ◽  
М. A. Laperishvili
Keyword(s):  
Renal Artery ◽  
Superior Mesenteric Artery ◽  
Female Patient ◽  
Mesenteric Artery ◽  
Left Kidney ◽  
Celiac Trunk ◽  
Heterozygous Mutation ◽  
Left Renal Artery ◽  
Moderate Activity ◽  
Negative Consequences

Objective:to analyze and present a clinical case of late diagnosis of Takayasu’s arteritis in a young female patient with long-term arterial hypertension.Materials and methods.The female patient G., born in 1989, had noted elevated arterial pressure (AP) of 150/90 mm Hg since she was 14. At 21 the following diagnosis was stated: Fibro-muscular dysplasia, stenosis of the left renal artery. Stenosis of the celiac trunk. Aneurisms of the branches of the superior mesenteric artery; prosthesis of the left renal artery was performed. Since the beginning of 2016, the patient has noted elevated AP of 200/110 mm Hg despite continuing hypotensive therapy. Diagnosis of Nonspecific aortoarteritis was proposed in May of 2017. Methylprednisolone therapy was administered: 250 mg No. 2 intravenously, Prednisolone: 25 mg a day orally. Due to signs of decreased blood flow to the left kidney, in August of 2017 extracorporeal repeat prosthesis of the left renal artery, bypass of the right middle renal artery with reversed autovein were performed.Results.During examination in October of 2017, the patient complained of weakness, frequent elevated AP of 200/110 mm Hg. In blood test: hemoglobin 106 g/l, erythrocyte sedimentation rate 38 mm/h, C-reactive protein 25 mg/l. A heterozygous mutation in the methylenetetrahydropholate reductase, a heterozygous mutation in the factor V gene (G1691A) were identified. Homocysteine level was normal, infection and oncological pathology were excluded. The following diagnosis was made: Takayasu»s arteritis type IV affecting the aorta and its branches, moderate activity. Occlusion of the celiac trunk. Aneurisms of the branches of the superior mesenteric artery. Critical stenosis of the left renal artery. Thrombosis of the aorto-renal prosthesis. Hypoplasia of the left kidney. Prednisolone 50 mg a day, metoprolol 50 mg a day, valsartan 160 mg a day, acetylsalicylic acid 100 mg a day were prescribed.Conclusion.The presented clinical observation shows the importance of comprehensive examination of young patients complaining of elevated AP for many years. Due to untimely diagnosis and absence of pathogenetic therapy, the patient suffered negative consequences of surgical treatment.

scholarly journals A Rare Case of Xanthogranulomatous Pyelonephritis with Spontaneous Renocolic Fistula and IVC Thrombosis

2021 ◽  
Vol 2021 ◽  
pp. 1-4
Author(s):  
Daniele Sforza ◽  
Leandro Siragusa ◽  
Matteo Ciancio Manuelli ◽  
Linda De Luca ◽  
Bruno Sensi ◽  
...  
Keyword(s):  
Damage Control ◽  
Primary Anastomosis ◽  
Loop Ileostomy ◽  
Left Kidney ◽  
Vena Cava ◽  
Xanthogranulomatous Pyelonephritis ◽  
Control Procedure ◽  
Filter Placement ◽  
Vessel Thrombosis

Xanthogranulomatous pyelonephritis (XGPN) is a rare disorder affecting the kidney which can fistulise to the colon in exceptional cases. We herein report a case of XGPN with renocolic fistula and large vessel thrombosis presenting with sepsis and pulmonary embolism. Preoperative diagnosis and strategic planning resulted in successful management. A 64-year-old woman presented to the emergency department with abdominal pain and a septic condition, corroborated by venous thromboembolism. Workup diagnosed a left renal abscess with calicocolic fistula. Scintigraphy confirmed a nonfunctioning left kidney. The patient underwent inferior vena cava filter placement and staged surgery. The first, damage control procedure was a loop ileostomy. Ten days later, when the patient’s conditions improved, she underwent left nephrectomy and left colectomy with primary anastomosis. Finally, a year later, the ileostomy was closed. At follow-up, the patient was well, with unremarkable renal function. Scrupulous diagnostics, multidisciplinary decision making, and staged intervention have been key to optimal outcome.

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