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February 1956

Ligation of the Inferior Vena Cava After Nephrectomy

Author Affiliations

Fort Wayne, Ind.
Specialist certified by the American Board of Surgery (Drs. Bolman and Lloyd); fellow, American College of Surgeons [Western Surgical Association, 1955 (Dr. Bolman)].

AMA Arch Surg. 1956;72(2):194-196. doi:10.1001/archsurg.1956.01270200010002

We believe the case reported here to be the first of its kind reported, and, since the indication involved must certainly recur, we believe it to represent an addition to the surgeon's armamentarium.

Virchow,* between 1846 and 1856, suggested that embolism was related to phlebitis of the legs.

Kocher † first ligated an inferior vena cava for surgical trauma in 1883. Billroth repeated the procedure in 1885. Both operations were fatal. The first success with ligation for trauma is credited to Bottini, reported by Costa in 1921, in the Italian Journal of Surgery. Trendelenberg ligated two venae cavae in 1906 and a third in 1910, all for thrombo-phlebitis with septicemia. Pfaff3 stressed the fact, in 1926, that it was safer to ligate the injured inferior vena cava below the level of the renal veins than to attempt to repair it.

The concept of ligation for the prevention of emboli