[A surgical case of intrapericardial inferior vena cava injury complicating liver injury caused by a blunt trauma].

Abstract

A 63-year-old man was brought to our hospital 20 minutes after sustaining blunt injury. He had been struck by a steel frame weighing about 700 kg that had fallen from a height of 2 meters. On admission, he was in cardiogenic shock with a systolic pressure of 70 mmHg and a pulse rate of 130 beats/minute. There was no apparent open wound and no brain injury was suspected. Echocardiography and chest computed tomogram showed cardiac tamponade, and abdominal computed tomogram showed liver injury. We performed emergency operation under cardio-pulmonary bypass standby. Laceration of the inferior vena cava at the right atrium junction was noticed. We had to perform IVC repair under cardio-pulmonary bypass because of massive bleeding. Liver injury was repaired after neutralization of systemic heparinazation. The patient developed respiratory, hepatic and renal failure during his postoperative course; however, he was discharged on postoperative day 39. Intrapericardial IVC injury caused by blunt trauma is a very rare event. Reconstruction can be performed successfully under cardio-pulmonary bypass.