Treatment of a penetrating inferior vena cava injury using doctor-helicopter emergency medical service and direct-to-operating room resuscitation in Korea: a case report

Dongmin Seo, Jieun Kim, Jiwon Kim, Inhae Heo, Jonghwan Moon, Kyoungwon Jung, H. Jung
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Abstract

Inferior vena cava (IVC) injuries can have fatal outcomes and are associated with high mortality rates. Patients with IVC injuries require multiple procedures, including prehospital care, surgical techniques, and postoperative care. We present the case of a 67-year-old woman who stabbed herself in the abdomen with a knife, resulting in an infrarenal IVC injury. We shortened the transfer time by transporting the patient using a helicopter and decided to perform direct-to-operating room resuscitation by a trauma physician in the helicopter. The patient underwent laparotomy with IVC ligation for damage control during the first operation. The second-and third-look operations, including previous suture removal, IVC reconstruction, and IVC thrombectomy, were performed by a trauma surgeon specializing in cardiovascular diseases. The patient was discharged without major complications on the 19th postoperative day with rivaroxaban as an anticoagulant medication. Computed tomography angiography at the outpatient clinic showed that thrombi in the IVC and both iliac veins had been completely removed. Patients with IVC injuries can be effectively treated using a trauma system that includes fast transportation by helicopter, damage control for rapid hemostasis, and expert treatment of IVC
在韩国使用医生直升机急救服务和直接到手术室复苏治疗下腔静脉穿透性损伤:病例报告
下腔静脉(IVC)损伤可能导致致命后果,死亡率也很高。IVC 损伤患者需要进行多种治疗,包括院前护理、外科技术和术后护理。我们介绍了一名 67 岁女性的病例,她用刀刺伤自己的腹部,导致肾下 IVC 损伤。我们使用直升机运送患者,缩短了转运时间,并决定由直升机上的创伤医生直接在手术室对患者进行抢救。在第一次手术中,患者接受了腹腔镜手术并结扎了 IVC 以控制损伤。第二和第三次手术,包括之前的缝线拆除、IVC 重建和 IVC 血栓切除术,均由心血管疾病专业的创伤外科医生完成。术后第19天,患者在利伐沙班的抗凝治疗下无重大并发症出院。门诊的计算机断层扫描血管造影显示,IVC和两条髂静脉中的血栓已被完全清除。使用创伤系统可以有效治疗 IVC 损伤患者,该系统包括直升机快速运送、快速止血的损伤控制以及 IVC 的专家治疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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11 weeks
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