Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries
We describe the surgical dilemma of an adult male who arrived with a penetrating injury to the suprarenal inferior vena cava (IVC), where conventional intraoperative hemorrhage control failed. Our team innovated by using an atriocaval shunt for temporization of the injury during resuscitation, enabl...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2025-07-01
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| Series: | Trauma Surgery & Acute Care Open |
| Online Access: | https://tsaco.bmj.com/content/10/3/e001882.full |
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| author | Jessica Potter Stefan Leichtle Edgar B Rodas Mike Mallah Kyle J Alexander Sierra L Patterson William B French Levi Procter Brian J Strife Leopoldo Fernandez Michel B Aboutanos |
| author_facet | Jessica Potter Stefan Leichtle Edgar B Rodas Mike Mallah Kyle J Alexander Sierra L Patterson William B French Levi Procter Brian J Strife Leopoldo Fernandez Michel B Aboutanos |
| author_sort | Jessica Potter |
| collection | DOAJ |
| description | We describe the surgical dilemma of an adult male who arrived with a penetrating injury to the suprarenal inferior vena cava (IVC), where conventional intraoperative hemorrhage control failed. Our team innovated by using an atriocaval shunt for temporization of the injury during resuscitation, enabling us to return to the operating room and perform primary repair. Notably, the prolonged use of the atriocaval shunt as a damage control strategy represents a novel application, as it remained in place for several hours—a first in reported cases. We detail this technique, the multidisciplinary approach to managing concomitant severe injuries, and the resulting complications and outcomes. This case highlights the challenges of managing suprarenal IVC injuries and demonstrates the potential role of prolonged atriocaval shunting as a damage control strategy. |
| format | Article |
| id | doaj-art-65d379a7ff024c72a2007c054531d8dc |
| institution | DOAJ |
| issn | 2397-5776 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | Trauma Surgery & Acute Care Open |
| spelling | doaj-art-65d379a7ff024c72a2007c054531d8dc2025-08-20T03:12:32ZengBMJ Publishing GroupTrauma Surgery & Acute Care Open2397-57762025-07-0110310.1136/tsaco-2025-001882Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuriesJessica Potter0Stefan Leichtle1Edgar B Rodas2Mike Mallah3Kyle J Alexander4Sierra L Patterson5William B French6Levi Procter7Brian J Strife8Leopoldo Fernandez9Michel B Aboutanos10Department of Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USASurgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Surgery, Medical University of South Carolina, Charleston, South Carolina, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USACollege of Medicine, Medical University of South Carolina, Charleston, South Carolina, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Radiology, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USADepartment of Surgery, Virginia Commonwealth University, Richmond, Virginia, USAWe describe the surgical dilemma of an adult male who arrived with a penetrating injury to the suprarenal inferior vena cava (IVC), where conventional intraoperative hemorrhage control failed. Our team innovated by using an atriocaval shunt for temporization of the injury during resuscitation, enabling us to return to the operating room and perform primary repair. Notably, the prolonged use of the atriocaval shunt as a damage control strategy represents a novel application, as it remained in place for several hours—a first in reported cases. We detail this technique, the multidisciplinary approach to managing concomitant severe injuries, and the resulting complications and outcomes. This case highlights the challenges of managing suprarenal IVC injuries and demonstrates the potential role of prolonged atriocaval shunting as a damage control strategy.https://tsaco.bmj.com/content/10/3/e001882.full |
| spellingShingle | Jessica Potter Stefan Leichtle Edgar B Rodas Mike Mallah Kyle J Alexander Sierra L Patterson William B French Levi Procter Brian J Strife Leopoldo Fernandez Michel B Aboutanos Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries Trauma Surgery & Acute Care Open |
| title | Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries |
| title_full | Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries |
| title_fullStr | Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries |
| title_full_unstemmed | Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries |
| title_short | Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries |
| title_sort | prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal ivc injury with a multitude of complex abdominal injuries |
| url | https://tsaco.bmj.com/content/10/3/e001882.full |
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