• Justin Hurie, Peter Ehrlich, Valerie Castle, and Jonathan L Eliason.
• Department of Surgery, University of Michigan, Ann Arbor, 48109, USA. justin.hurie@gmail.com
• Ann Vasc Surg. 2011 Jan 1;25(1):132.e13-5.

AbstractInjuries to the inferior vena cava (IVC) are highly lethal and are usually associated with gunshot wounds. Blunt injury to the IVC is a rare entity that is usually located in the retrohepatic space. We present the case of an infrarenal caval disruption in a 9-year-old as a result of minimal blunt trauma. A computed tomography scan showed that the patient had a large retroperitoneal hematoma associated with IVC disruption and proximal thrombus just below the renal veins. There was no evidence of either arterial or other intra-abdominal injuries. The patient had a fall in hematocrit and abdominal tenderness prompting operative exploration. Before laparotomy, bilateral balloon occlusion devices were placed in both femoral veins. The patient was noted to have a total disruption of his IVC just above the origin of his iliac veins. The anterior two-third of the IVC was avulsed, thus leaving the posterior portion against the retroperitoneum. Given the patient's hemodynamic instability and amount of venous damage, the IVC was oversewn and a damage control operation was undertaken. The following day, the patient was brought back to the operating room for a second-look laparotomy and abdominal closure. A pathologic examination revealed a high-grade spindle cell sarcoma. Blunt injury to the IVC is a rare entity and its location outside of the retrohepatic space should alert the surgeon to a potential underlying malignant etiology.Published by Elsevier Inc.

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