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Wartime major venous vessel injuries

Narcis Hudorovi^*

Department of Endo and Vascular Surgery, University Hospital ‘Sestre milosrdnice’, Zagreb, Croatia

*Correspoding author. University Department of Surgery, University Hospital ‘Sestre milosrdnice’, 10000 Zagreb, Croatia, Vinogradska 29. Tel.: +385-1-46-40-774; fax: +385-1-37-68-292.

E-mail address: narcis.hudorovic{at}zg.htnet.hr (N. Hudorovi).

The aim of this study is to declare our experience and to identify the important factors that influence the mortality and morbidity in patients with combat-related penetrating wounds of the abdomen (CR-PWA) with major venous vessel injuries. Twenty-six wounded with combat-related injuries of major abdominal venous vessels, admitted in the University Clinic cardiovascular surgery department during the period from 1 August 1991 through 30 October 1995, were analyzed. Patients with concomitant injured arteries and extra-abdominal injuries (n=150; 85.2%) were excluded from this study. The Penetrating Abdominal Trauma Index (PATI) score for each patient was calculated. Fifteen patients (57.69%) sustained with PATI score greater than 25 died. The mean duration of hospitalization was 16 days (range 0–86). The average hospitalization time for those surviving their complications was 17 days with a PATI of 25 or less, and 43 days with a score more than 25. Three clinical assessments of the long-term outcome were performed after a median of about 3, 5 and 10 years, respectively. Surviving patients (42.31%) were symptom free and had normal Duplex scans as well as no other surgical related complications. Higher PATI scores, postoperative complications and reoperations exert an unfavorable effect on patient outcome.

Key Words: Venous injuries; War; Wounds; Penetrating-complications