272 Repair of the Inferior Vena Cava With Autogenous Peritoneo-Fascial Patch Graft Following Abdominal Trauma: A Case Report Mustafa Emmiler, MD, Cevdet Ugur Kocogullari, MD, Sezgin Yilmaz, MD, and Ahmet Cekirdekci, MD accessibility of the injured vein have been directly correlated with survival in IVC injury. 2 All concen- trated efforts should be made to repair the IVC pri- marily, reserving the caval ligation for lifesaving situations. Unfortunately, the routine ligation of the IVC causes lower limb edema and clinical sequelae, such as pain, swelling, and skin alterations. 3 There are several methods to repair the IVC injury. The pri- mary repair, end to end anastomosis, endovascular stenting or graft interposition with autogenous, or synthetic materials should be considered in selected cases. However, every case should be evaluated in its own condition, and surgical approach should be adapted to the individual need of the patient. In the present case, we report a patient with IVC injury repaired with autogenous peritoneo-fascial (APF) graft. We have used APF graft in traumatic IVC injury for the first time. Case Report A 19-year-old man was referred to our hospital due to IVC laceration following a severe penetrated A bdominal vascular injuries are among the most challenging and lethal injuries in patients who have suffered from trauma. Inferior vena cava (IVC) is the most frequently injured vein during the blunt or penetrating trauma. Because IVC is a low pressure and high-flow vein, the laceration of it is associated with severe mortality rate and potential catastrophic complications. Fortunately, the overall incidence is 0.9 to 2.3 per 100 000 populations. 1 The key to successful management of IVC injuries lies in immediate control of hemorrhage and repairing the vein in accessible cases. However, the exposure of IVC is difficult because of its protected anatomical location, as well as the presence of large retroperi- toneal hematoma accompanying the severe trauma. The severity of the injury, anatomical localization, and Abdominal vascular injuries are among the most chal- lenging and lethal injuries in traumatized patients. Inferior vena cava is the most frequently injured vein during the blunt or penetrating trauma. The primary repair, end to end anastomosis, endovascular stenting, or graft interposition with autogenous or synthetic mate- rials should be considered in selected cases. However, in cases the synthetic graft was preferred, intestinal con- taminations due to small or large bowel perforation accompanying the trauma have been cited as a limiting factor for the use of such grafts as in the current case. However, a previous history of lower leg variceal surgery prevents the use of great saphenous vein as a graft. So in the present case, the authors report a patient with inferior vena cava injury repaired with autogenous peritoneo- fascial graft. The authors have used APF graft in trau- matic inferior vena cava injury for the first time. Keywords: trauma; injury; inferior vena cava; repair; autogenous peritoneo-fascial graft From the Cardiovascular Surgery Department (ME, CUK, AC), and General Surgery Department (SY), The Faculty of Medicine, Kocatepe University, Ahmet Necdet Sezer Research and Education Hospital I . zmir Yolu, Afyonkarahisar,Turkey. Address correspondence to: Sezgin Yilmaz MD, Örnekevler Mah. Çig˘dem Sok., As¸ékbey Apt., 8/5 Afyon-Turkey; e-mail: drsezginyilmaz @gmail.com. Vascular and Endovascular Surgery Volume 42 Number 3 June/July 2008 272-275 © 2008 Sage Publications 10.1177/1538574407311604 http://ves.sagepub.com hosted at http://online.sagepub.com