Mesenteric Vascular Injury: An Appraisal of Current Management

Abstract

Injury to the visceral vasculature has a high mortality rate. A retrospective evaluation identified 11 men and 4 women (sixteen to thirty-three years) who sustained nine gunshot injuries, four stab wounds, and two cases of blunt trauma. Eight patients had associated organ trauma. Seven patients arrived in the Emergency Department with a systolic blood pressure < 90 mm Hg; 6 died. Blood loss varied from 2,000 to 15,000 mL. All vascular injuries except one (saphenous vein patch) underwent direct repair; no synthetic material was used. Nine survivors (three stab wounds, six gunshot injuries) and six deaths (three gunshot wounds, two blunt traumas, one stab wound) were reported, for a 40% mortality rate. Second-look procedures were undertaken during the latter part of the series with seemingly better results.