Abstract:
INTRODUCTION : Penetrating injury may involve the major vessels in the abdomen. Injury to the abdominal
inferior vena cava (IVC) is uncommon and is usually caused by gunshot wounds. Mortality from IVC
injuries is high and has changed little over time.
AIM : The aim of the study was to report a series of IVC injuries from an urban trauma unit and to
compare this with reports from similar institutions.
METHOD : A retrospective review of penetrating abdominal injuries at Kalafong Hospital from 1993 to
2010 was performed. All cases of injury to the IVC were retrieved and the following data recorded:
patient demographics, incident history, origin of referral, description of the IVC injury, associated
injuries, operative management, hospital stay and outcome. The results were compared to those from
similar institutions.
RESULTS : Twenty-seven patients with IVC injuries were treated. All were caused by gunshot wounds, and
all had associated intra-abdominal injuries. The majority (56%) of injuries were infrarenal. The injury
was managed most commonly by venorrhaphy and, when successful, all the patients survived. A third of
patients with infrarenal injuries died, some after exploration of a stable peri-caval haematoma. Ten of
the patients died (37%), half of them during surgery. These results are similar to those from similar
institutions from earlier time periods.
CONCLUSIONS : This report concurs with other studies. IVC injury carries a high mortality rate and that this
has not improved over several decades. Less aggressive management of some stable patients or stable
injuries is proposed by the authors for possible improvement of the mortality rate.
