A case of superior mesenteric vein injury treated with ligation

Abstract

A 35 year-old man was brought to our emergency room for blunt abdominal trauma. On arrival, he was in severe shock and emergency laparotomy was performed, which revealed the disruption of the superior mesenteric vein (SMV), and injuries of the pancreas and duodenum. Based on shock vitals and severe SMV damage, damage control strategy with SMV ligation was performed. The abdominal fascia was not closed under open abdomen management (OAM). For the secondary operation, the horizontal portion of the duodenum required resection due to severe damage. The gastrointestinal reconstruction and abdominal closure were not performed due to edema of the intestines and, resulting in the continued OAM. Due to risk of intestinal perforation, we decided to resect the fragile edematous intestines and close the abdominal fascia. On the 10th day, the patient underwent resection of 120cm of edematous jejunum and closure of the abdominal fascia. The patient was discharged on the 97th day post admission.