Nonoperative Management of a Penetrating Injury to the Retrohepatic Inferior Vena Cava

Given the anatomic confines of the region-the reduced ability to expose, control, and ultimately repair these injuries it is no wonder that there is an upwards of a 70 per cent mortality rate.1 Although no doubt remains as to the necessity of operative repair in patients with active IVC hemorrhage, there is less certainty in patients who present with contained injury or hematoma. Case Description The patient is a 25-year-old male who presented to the trauma emergency department of University Hospital in Newark, New Jersey, with two right-sided gunshot wounds: a posterior, paraspinal wound located at the T11 level and a posterior axillary line wound located at the T9 to T10 level.