In spite of diagnostic and therapeutic advances, injuries to the posterior hepatic segments and/or retro-hepatic vena cava are diagnosed during emergency surgery for bleeding control in traumic instability. Preoperative diagnostic tests are generally ineffective in these cases. The reported mortality for these injuries ranges from 30% to 80%. The knowledge of the surgical maneuvers to expose this abdominal region is helpful for injuries management, and to prevent inadvertent injuries during surgical exploration.

To demonstrate the liberation and rotation of the lateral and medial wall of the retrohepatic vena cava to treat injuries of this vein, we will employ illustrations based on clinical cases and 3D animation (virtual man).

Two clincal cases shows retrohepatic vena cava injury. One on the left side near adrenal gland, and other medial side of the retrohepatic vena cava.

The knowledge of liberation and rotation for exposure of the lateral and medial wall of the retrohepatic vena cava make easier the injury exposure and avioda inadvertent injuries.