• Alberto García, Mauricio Millán, Daniela Burbano, Carlos A Ordoñez, Michael W Parra, González HadadAdolfoAhttps://orcid.org/0000-0001-5862-4906Universidad del Valle, Facultad de Salud, Escuela de Medicina, Department of Surgery. Division of Trauma and Acute Care Surgery, Cali, Colombia. Universidad del Valle Universidad del Valle Facultad, Mario Alain Herrera, Luis Fernando Pino, Fernando Rodríguez-Holguín, Alexander Salcedo, María Josefa Franco, Ricardo Ferrada, and Juan Carlos Puyana.
• Fundación Valle del Lili. Department of Surgery. Division of Trauma and Acute Care Surgery, Cali, Colombia. Fundación Valle del Lili Department of Surgery Division of Trauma and Acute Care Surgery Cali Colombia.
• Colomb Medica. 2021 Apr 1; 52 (2): e4064808.

AbstractIn patients with abdominal trauma who require laparotomy, up to a quarter or a third will have a vascular injury. The venous structures mainly injured are the vena cava (29%) and the iliac veins (20%), and arterial vessels are the iliac arteries (16%) and the aorta (14%). The initial approach is performed following the ATLS principles. This manuscript aims to present the surgical approach to abdominal vascular trauma following damage control principles. The priority in a trauma laparotomy is bleeding control. Hemorrhages of intraperitoneal origin are controlled by applying pressure, clamping, packing, and retroperitoneal with selective pressure. After the temporary bleeding control is achieved, the compromised vascular structure must be identified, according to the location of the hematomas. The management of all lesions should be oriented towards the expeditious conclusion of the laparotomy, focusing efforts on the bleeding control and contamination, with a postponement of the definitive management. Their management of vascular injuries includes ligation, transient bypass, and packing of selected low-pressure vessels and bleeding surfaces. Subsequently, the unconventional closure of the abdominal cavity should be performed, preferably with negative pressure systems, to reoperate once the hemodynamic alterations and coagulopathy have been corrected to carry out the definitive management.Copyright © 2021 Colombia Medica.

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