Ligation of the inferior vena cava in penetrating pediatric trauma

Penetrating trauma in children is on the rise in the United States, often leading to severe injuries. Destructive injuries to the inferior vena cava (IVC) are rare in children, and outcomes of ligation are not well-described. This is a retrospective chart review of the cases and outcomes of two young children who required IVC ligation following abdominal gunshot wounds. The children's ages ranged from 3 to 6 years old. They both had concomitant duodenal injuries and additional intestinal injuries. The first patient also had a spinal cord injury. Their course was complicated by profound shock, breakdown of intestinal repairs, renal failure, and a necrotizing groin soft tissue infection, but they ultimately made a near-complete recovery. The second patient had a smooth postoperative course. Neither patient developed significant lower extremity edema. Ligation of the IVC in pediatric penetrating trauma patients is a viable and life-saving option but can be associated with complications.