Two-stage surgical treatment of inferior vena cava traumatic rupture including urgent transport to a specialized unit

Inferior vena cava injury as well as major liver injury remains a formidable treatment challenge. The most imminent danger is life-threatening bleeding. In this report, we present a case of polytrauma (Injury Severity Score 35) with arupture of the juxtahepatic inferior vena cava which was successfully treated using two-stage approach. The first part of the treatment consisted of damage control laparotomy at a level I trauma center. After stabilization, the patient was air-transported to receive the definitive treatment at a tertiary care facility experienced in hepatopancreatobiliary and transplantation surgery. As the level of injury was not clear prior to the second stage surgery, a cardiac team also assisted the operation. The second stage procedure was uneventful. The patient is doing well and is preparing to return to work. We believe that experience with major abdominal, thoracic and liver transplantation surgery is beneficial in such cases.