2018 Volume 38 Issue 4 Pages 609-615
It is rare for any injury to occur to the superior mesenteric artery (SMA) and/or superior mesenteric vein (SMV). Occasionally, however, such injuries cause severe hemorrhagic shock. In 6,084 trauma victims treated in our institute during the six years from 2011, there were 52 SMA/V injuries (0.85％, 50 cases due to blunt injury, 2 cases due to penetrating injury) requiring a hemostatic laparotomy. In 26 cases (24 cases due to blunt trauma), injuries were found in the more proximal zone (classification by Fullen Zone I to Ⅲ) and required a surgical approach for the vessels. All SMA injuries were ligated to control bleeding, and SMV injuries were repaired as much as possible. Subsequently, a survival rate of 76.9％ could be obtained after 6 years. Although cardiac arrest is often imminent due to the massive bleeding caused by SMA/V injury, controlling hemorrhage and avoiding intestinal ischemia should be promptly and accurately performed, even in those circumstances under which is difficult to approach the injured site accompanied with a large amount of blood outflow. Accordingly, our treatment tactics is thought to be appropriate in these series.
