{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,24]],"date-time":"2025-08-24T17:40:04Z","timestamp":1756057204375,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"3","license":[{"start":{"date-parts":[[2025,7,19]],"date-time":"2025-07-19T00:00:00Z","timestamp":1752883200000},"content-version":"unspecified","delay-in-days":18,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Trauma Surg Acute Care Open"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:p>We describe the surgical dilemma of an adult male who arrived with a penetrating injury to the suprarenal inferior vena cava (IVC), where conventional intraoperative hemorrhage control failed. Our team innovated by using an atriocaval shunt for temporization of the injury during resuscitation, enabling us to return to the operating room and perform primary repair. Notably, the prolonged use of the atriocaval shunt as a damage control strategy represents a novel application, as it remained in place for several hours\u2014a first in reported cases. We detail this technique, the multidisciplinary approach to managing concomitant severe injuries, and the resulting complications and outcomes. This case highlights the challenges of managing suprarenal IVC injuries and demonstrates the potential role of prolonged atriocaval shunting as a damage control strategy.<\/jats:p>","DOI":"10.1136\/tsaco-2025-001882","type":"journal-article","created":{"date-parts":[[2025,7,21]],"date-time":"2025-07-21T01:20:23Z","timestamp":1753060823000},"page":"e001882","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Prolonged atriocaval shunt utilization as a damage control tool for the management of juxtarenal IVC injury with a multitude of complex abdominal injuries"],"prefix":"10.1136","volume":"10","author":[{"given":"Edgar B","family":"Rodas","sequence":"first","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6774-0682","authenticated-orcid":false,"given":"Stefan","family":"Leichtle","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"},{"name":"Surgery Service Line, Inova Fairfax Medical Campus, Falls Church, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mike","family":"Mallah","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"},{"name":"Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3403-4420","authenticated-orcid":false,"given":"Kyle J","family":"Alexander","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sierra L","family":"Patterson","sequence":"additional","affiliation":[{"name":"College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B","family":"French","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"},{"name":"Department of Surgery, MedStar Washington Hospital Center, Washington, District of Columbia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Levi","family":"Procter","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Potter","sequence":"additional","affiliation":[{"name":"Department of Anesthesia, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brian J","family":"Strife","sequence":"additional","affiliation":[{"name":"Department of Radiology, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leopoldo","family":"Fernandez","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michel B","family":"Aboutanos","sequence":"additional","affiliation":[{"name":"Department of Surgery, Virginia Commonwealth University, Richmond, Virginia, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,7,20]]},"reference":[{"key":"2025082410194006000_10.3.e001882.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjsurg.2009.05.013"},{"key":"2025082410194006000_10.3.e001882.2","doi-asserted-by":"crossref","first-page":"e1","DOI":"10.1097\/XCS.0000000000000436","article-title":"Endovascular Balloon Occlusion of the Inferior Vena Cava in Trauma: A Single-Center Case Series","volume":"236","author":"Howell","year":"2023","journal-title":"J Am Coll Surg"},{"key":"2025082410194006000_10.3.e001882.3","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1177\/00031348211038556","article-title":"Contemporary Management and Outcomes of Injuries to the Inferior Vena Cava: A Prospective Multicenter Trial From PROspective Observational Vascular Injury Treatment","volume":"89","author":"Stonko","year":"2023","journal-title":"The American Surgeon"},{"key":"2025082410194006000_10.3.e001882.4","first-page":"469","article-title":"Management of penetrating juxtahepatic inferior vena cava injuries under total vascular occlusion","volume":"184","author":"Khaneja","year":"1997","journal-title":"J Am Coll Surg"},{"key":"2025082410194006000_10.3.e001882.5","first-page":"555","article-title":"The atriocaval shunt","volume":"207","author":"Burch","year":"1988","journal-title":"Facts and Fiction Ann Surg"}],"container-title":["Trauma Surgery &amp; 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