Traumatic Injuries to the Portal Vein: Case Study

Jonathan Pearl, Alexander Chao, Susan Kennedy, Bikram Paul, Peter M Rhee

Research output: Contribution to journalArticle

19 Scopus citations

Abstract

Background: Injuries to the portal vein are rare but devastating. Contemporary studies have debated the most effective management for this injury. The purpose of this case study was to provide an update on portal vein injury and add information regarding its management. Methods: A retrospective review investigated the 10-year experience with portal vein injury in a level 1 trauma center. Results. Of the 18,900 trauma patients (0.08%) evaluated during a 10-year period, 15 sustained injuries to the portal vein. All the injuries resulted from penetrating trauma, and the overall survival rate was 60% (9 of the 15 patients). Four patients died of exsanguination and two patients died later as a result of multisystem organ failure. Postoperative complications were common. Sepsis and wound infection were the most common postoperative complications, occurring in seven (78%) of the nine survivors. All the patients had associated nonvascular injuries, whereas 9 (60%) of the 15 had associated vascular injuries. Associated injuries to the other structures in the portal triad occurred in 7 (47%) of the 15 patients, and 5 (71%) of these patients survived. Survival rates by procedure were 86% for venorrhaphy and 67% for ligation. Conclusions: Injuries to the portal vein are rare. In this study, exsanguination was the main cause of death. The key to a favorable outcome is prompt control of hemorrhage with an early decision to proceed with either venorrhaphy or ligation. Ligation can be effective for the management of hemodynamically unstable patients.

Original languageEnglish (US)
Pages (from-to)779-782
Number of pages4
JournalJournal of Trauma
Volume56
Issue number4
Publication statusPublished - Apr 2004
Externally publishedYes

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Keywords

  • Injuries
  • Portal triad
  • Portal vein
  • Trauma
  • Wounds

ASJC Scopus subject areas

  • Surgery

Cite this

Pearl, J., Chao, A., Kennedy, S., Paul, B., & Rhee, P. M. (2004). Traumatic Injuries to the Portal Vein: Case Study. Journal of Trauma, 56(4), 779-782.