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Thoracic venous injuries: an imaging and management overview

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Abstract

Thoracic venous injuries are predominantly attributed to traumatic and iatrogenic causes. Gunshot wounds and knife stabbings make up the vast majority of penetrating trauma whereas motor vehicle collisions are the leading cause of blunt trauma to the chest. Iatrogenic injuries, mostly from central venous catheter complications are being described in growing detail. Although these injuries are rare, they pose a diagnostic challenge as their clinical presentation does not substantially differ from that of arterial injury. Furthermore, the highly lethal nature of some of these injuries provides limited literature for review and probably underestimates their true incidence. The widespread use of multi-detector computed tomography (MDCT) has increased the detection rate of these lesions in hemodynamically stable patients that survive the initial traumatic event. In this article, we will discuss and illustrate various causes of injury to each vein and their supporting CT findings while briefly discussing management. The available literature will be reviewed for penetrating, blunt, and iatrogenic injuries to the vena cava, innominate, subclavian, axillary, azygos, and pulmonary veins.

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Acknowledgments

We thank Juan Restrepo for Figs. 2 and 11.

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Authors and Affiliations

  1. Department of Radiology, University of Texas Health Science Center, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA

    Aftab A. Haq, Carlos S. Restrepo & Daniel Lamus

  2. Department of Radiology, University of Texas Health Science Center, Houston, TX, USA

    Daniel Ocazionez-Trujillo

  3. Department of Radiology, University of Colorado, Denver, CO, USA

    Daniel Vargas

Authors
  1. Aftab A. Haq
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  2. Carlos S. Restrepo
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  3. Daniel Lamus
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Correspondence to Aftab A. Haq.

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Haq, A.A., Restrepo, C.S., Lamus, D. et al. Thoracic venous injuries: an imaging and management overview. Emerg Radiol 23, 291–301 (2016). https://doi.org/10.1007/s10140-016-1386-1

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  • DOI: https://doi.org/10.1007/s10140-016-1386-1

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