Trauma to the inferior vena cava is associated with severe injuries of the liver (463-465). Consequent entry of hepatic tissue into the circulation leads to grossly evident emboli in the lungs (463-465). Microscopic evidence of hepatic tissue may not be seen in pulmonary vessels, raising the possibility that liver seen in the heart and pulmonary vessels was pushed there by external force (463). Microscopic emboli to the lungs support a vital reaction, i.e., an active circulation at the time of the trauma (Fig. 51; ref. 466).
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