TY  - JOUR
PY  - 2022//
TI  - Azygos vein lacerations, a rare injury from high-impact chest trauma: two cases and a review of the literature
JO  - International journal of surgery case reports
A1  - Li, Christine
A1  - Martin, Katherine
A1  - Read, David
SP  - e106778
EP  - e106778
VL  - 91
IS  - 
N2  - INTRODUCTION: Thoracic trauma is a significant cause of mortality, being responsible for 25% of trauma deaths. Despite this, azygos vein lacerations are rare, with only 35 published cases. We present two cases of azygos vein laceration over 21 years from 1999 to 2020 at a Level One Trauma Centre in Melbourne, Australia, as well as a review of the literature. CASE PRESENTATIONS: The first case is a 38-year-old male who fell eight metres from a motorbike jump. He arrived in our emergency department in extremis. The second case is an 81-year-old female driver who presented following a motor vehicle crash. Both patients had massive right haemothorax and haemodynamic instability, so were transferred to the operating theatre for emergency thoracotomies. Both patients survived to hospital discharge. <br><br>DISCUSSION: Of the 37 cases of azygos vein injury, including our two, 36 were due to blunt trauma and one from penetrating trauma. Sixteen survived to hospital discharge, producing a 43% mortality rate. Only one of these survivors was managed non-operatively, the remainder underwent emergency thoracotomy and azygos vein ligation. The mortality rate reduced to 31% in those who underwent thoracotomy (n = 29). Presentation was predominantly with shock (83%) and right hemithorax white-out on chest x-ray (81%). <br><br>CONCLUSION: Azygos vein injuries are a rare but important cause of thoracic haemorrhage in high-impact blunt trauma. They are often fatal, so management relies on expedient transfer to theatre.<p />  <p>Language: en</p>
LA  - en
SN  - 2210-2612
UR  - http://dx.doi.org/10.1016/j.ijscr.2022.106778
ID  - ref1
ER  -