Juxtahepatic Venous Injuries: Emergency Measures, Definitive Control, and Atriocaval Shunts

  • Donald D. TrunkeyEmail author
  • K. Shad Pharaon


The liver is one of the most frequently injured organs in abdominal trauma. The anterior location in the abdominal cavity and fragile parenchyma make this organ vulnerable to injury. Prior to World War II, the mortality from liver injuries that were diagnosed and operated on was very high. After World War II, a better working knowledge in the anatomy of the liver, popularized by Couinaud, and subsequent liver transplantation furthered our understanding of the liver and how to more safely operate. Even with these advances, until about twenty years ago, many liver injuries were still operated on with lethal outcomes. The operations were time consuming and prone to significant blood loss.


Liver Injury Hepatic Vein Inferior Vena Pringle Maneuver Portal Triad 
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Supplementary material

Video 6

Pringle maneuver (MP4 14015 kb)

Video 9

Hepatic vascular exclusion (MP4 99239 kb)

Video 12

Atriocaval shunt (MP4 256971 kb)

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  1. 1.Section of Trauma and Critical Care, Department of SurgeryOregon Health and Science UniversityPortlandUSA
  2. 2.Division of Trauma, Critical Care, and Acute Care Surgery, Department of SurgeryOregon Health and Science UniversityPortlandUSA
  3. 3.Division of Trauma and Acute Care Surgery, Surgical Critical CarePeaceHealth Southwest Medical CenterVancouverUSA

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