Wounds of the portal venous system

H. Harlan Stone, Timothy Fabian, Margaret L. Turkleson

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

During a 23-year interval, 83 patients with wounds of the portal and/or superior mesenteric veins underwent emergency laparotomy. Six (7%) of the injuries were due to blunt trauma, while penetrating wounds accounted for the remaining 77 (93%). With one exception, associated organ injuries were routinely present and involved 120 other major vascular structures in 59 (71%) of the patients. Five patients with both portal and superior mesenteric vein injury and 3 others with isolated portal venous injury exsanguinated before repair could be accomplished. Lateral phleborrhaphy gave survival in 24 of 34 patients so treated. End-to-end reanastomosis of the portal vein was successful in only 1 of 3 patients on whom it was attempted, while the single portacaval shunt led to a metabolic death. Of the initial 17 patients having vein ligation as a desperation measure, there were 7 survivors. Subsequent immediate application of this technique whenever lateral repair was impossible or impractical was successful in 17 of 20 so managed. Death resulted from hemorrhagic shock (20), its attendant coagulopathy (7), or renal failure (2) in 29 patients. Two deaths were the result of failure to over-transfuse appropriately when portal venous ligation or thrombosis with its attendant splanchnic sequestration led to significant peripheral hypovolemia. The overall mortality rate was 41%, with individual mortality rates of 46% and 27% for the portal and superior mesenteric veins, respectively. There was no survival if both veins had been injured.

Original languageEnglish (US)
Pages (from-to)335-340
Number of pages6
JournalWorld Journal of Surgery
Volume6
Issue number3
DOIs
StatePublished - May 1 1982

Fingerprint

Portal System
Mesenteric Veins
Wounds and Injuries
Ligation
Veins
Penetrating Wounds
Surgical Portacaval Shunt
Hypovolemia
Survival
Viscera
Hemorrhagic Shock
Mortality
Portal Vein
Laparotomy
Renal Insufficiency
Blood Vessels
Survivors
Emergencies
Thrombosis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Stone, H. H., Fabian, T., & Turkleson, M. L. (1982). Wounds of the portal venous system. World Journal of Surgery, 6(3), 335-340. https://doi.org/10.1007/BF01653551

Wounds of the portal venous system. / Stone, H. Harlan; Fabian, Timothy; Turkleson, Margaret L.

In: World Journal of Surgery, Vol. 6, No. 3, 01.05.1982, p. 335-340.

Research output: Contribution to journalArticle

Stone, HH, Fabian, T & Turkleson, ML 1982, 'Wounds of the portal venous system', World Journal of Surgery, vol. 6, no. 3, pp. 335-340. https://doi.org/10.1007/BF01653551
Stone HH, Fabian T, Turkleson ML. Wounds of the portal venous system. World Journal of Surgery. 1982 May 1;6(3):335-340. https://doi.org/10.1007/BF01653551
Stone, H. Harlan ; Fabian, Timothy ; Turkleson, Margaret L. / Wounds of the portal venous system. In: World Journal of Surgery. 1982 ; Vol. 6, No. 3. pp. 335-340.
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