Successful Treatment of GSW to the Intrapericardial Inferior Vena Cava wall: Case Report

INTRODUCTION: Penetrating traumas to the thorax could be potentially serious. Vena caval wounds are highly lethal, so that half of the patients die before reaching the hospital, and another 50% may die perioperatively. Although rare, most of them are the result of gunshot wounds. PRESENTATION OF CASE: We report a 13-year-old boy shot by an air gun through his right hemithorax. During surgery, an air gun bullet appeared right within the wall of the intrapericardial inferior vena cava (IVC). DISCUSSION: Traumas to the thoracic contents as vena cava are inevitable, presenting mostly with haemo or pneumothorax. If the victim reaches the operating room alive, the approach to his or her vena cava rupture remains a challenge in the hands of surgeons. In this case, the surgeon, following the bullet removal, repaired the penetration immediately by direct suturing because clamping the inferior vena for its thin wall can expand the rupture, also blocking systemic venous return. CONCLUSION: The surgeon in a general trauma center that is almost lacking cardiopulmonary pump can repair the vital injuries to the IVC with the technique of direct suturing.