Splenic Vein Turndown Repair in Superior Mesenteric Vein Trauma: A Reasonable Alternative

Abstract

Objective: To determine previous experience and results of autologous splenic vein graft repairs in traumatic superior mesenteric vein (SMV) avulsions. Design of Study: Systemic review was conducted for SMV trauma and methods of repair between 1897 and 2010. Articles were further analyzed for use of the splenic vein as an alternative conduit and were included in this study. Results: Of the 56 articles identified during our search, 4 included use of the splenic vein as an autologous vein graft. A total of 5 cases using the splenic vein turndown repair were identified in addition to our case. Of the 6 patients, 4 survived. Only one other case exists regarding the successful use of the splenic vein turndown technique in blunt abdominal trauma. Conclusion: There is little information regarding the feasibility and success of this technique in traumatic SMV disruption. Future studies are required to assess its role in abdominal vascular trauma.

Keywords

abdominal vascular trauma splenic vein superior mesenteric vein

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References

Stone HH , Fabian TC , Turkleson ML Wounds of the portal venous system. World J Surg. 1982;6(3):335-341.

Bostwick J. , Stone HH Trauma to portal venous system. South Med J. 1975;68(11):1369-1372.

Graham JM , Mattox KL , Beall AC Jr. Portal venous system injuries. J Trauma. 1978 ;18(6):419-422.

Coimbra R. , Filho AR , Nesser RA , Rasslan S. Outcome from traumatic injury of the portal and superior mesenteric veins . Vasc Endovascular Surg. 2004;38(3):249-255.

Ulvestad LE Repair of laceration of superior mesenteric artery acquired by non-penetrating injury to the abdomen. Ann Surg. 1954;140(5):752-754.

Asensio JA , Petrone P. , Garcia-Nuñez L. , Healy M. , Martin M. , Kuncir E. Superior mesenteric venous injuries: to ligate or to repair remains the question . J Trauma. 2007;62(3):668-675.

Fraga GP , Bansal V. , Fortlage D. , Coimbra R. A 20-year experience with portal and superior mesenteric venous injuries: has anything changed? Eur J Vasc Endovasc Surg. 2009;37(1): 87-91.

Courcy PA , Brotman S. , Oster-Granite ML , Soderstrom CA , Siegel JH , Cowley RA Superior mesenteric-artery and vein injuries from blunt abdominal-trauma. J Trauma. 1984;24(9): 843-845.

Leon LR Jr , Hughes JD , Psalms SB , et al. Portomesenteric reconstruction during Whipple procedures: review and report of a case. Vasc Endovascular Surg. 2007;41(6):537-546.

10.

Delaurentis DA , Tyson RR Surgical reconstruction of major veins. Circulation. 1964;29(4 Suppl 1):176-180.

11.

Busuttil RW , Storm FK , Wilbur BG , Longmire WP Jr. Use of splenic vein in reconstruction of portal and superior mesenteric veins after traumatic injury. Surg Gynecol Obstet. 1977;145(4): 591-593.

12.

Wiencek RG , Wilson RF Abdominal venous injuries. J Trauma. 1986;26(9):771-778.

13.

Liu M. , Lui WY , Lee CS , Kuo SM , P’eng FK. Superior mesenteric vein severance from blunt abdominal trauma report of a case. Taiwan Yi Xue Hui Za Zhi. 1989;88(2):183-185.