# Sonographic Identification of an Inferior Vena Cava Tear in a Penetrating Injury

## TL;DR

A rare case shows how ultrasound can detect a tear in a major vein from a stab wound, helping identify life-threatening injuries quickly.

## Contribution

This case demonstrates the potential of eFAST ultrasound to directly visualize an inferior vena cava tear in a penetrating injury.

## Key findings

- A bedside eFAST identified a tear in the IVC wall and adjacent haematoma in a patient with a stab wound.
- The patient died despite immediate surgical intervention, emphasizing the severity of such injuries.
- The case suggests that IVC evaluation during eFAST can aid in early detection of critical vascular trauma.

## Abstract

Injuries to the inferior vena cava (IVC) from penetrating trauma are uncommon but carry a high risk of fatality due to the potential for rapid, massive haemorrhage. We present the case of a 56-year-old man who sustained a stab wound to the right lower chest and presented in profound haemorrhagic shock. A bedside extended Focused Assessment with Sonography for Trauma (eFAST) not only identified free abdominal fluid but also provided a direct, real-time visualisation of a tear in the IVC wall with an adjacent haematoma. Despite immediate surgical intervention, the patient died from his injuries. This case highlights a rare but critical sonographic finding, suggesting that evaluating the IVC during an eFAST exam can be a valuable tool for the early detection of life-threatening vascular injuries in haemodynamically unstable patients.