Dissection
Exsanguination
Hemorrhage
Hemostatics
Resuscitation

Mattox Maneuver

Injuries involving the abdominal aorta and central or left-sided retroperitoneal structures are among the most lethal challenges in trauma surgery, requiring rapid decision-making, precise anatomical knowledge, and coordinated team-based care. Initial treatment focuses on resuscitation, hemostatic maneuvers, and temporary vascular control. However, standard approaches may be insufficient when bleeding persists or vital structures remain inaccessible. Advanced exposure techniques are then required to isolate and secure injured vessels and organs safely, enabling definitive repair and reducing the risk of exsanguination or ischemic complications. The Mattox maneuver, or left medial visceral rotation, is an essential surgical exposure technique for controlling traumatic retroperitoneal hemorrhage. The maneuver involves mobilization of the left-sided viscera, including the spleen, pancreas, stomach, and descending colon, to expose the abdominal aorta and retroperitoneal structures. Indications include uncontrolled hemorrhage from the proximal abdominal aorta, left renal vessels, or major retroperitoneal organs. Contraindications comprise hemodynamic instability precluding extensive dissection or extensive adhesions from prior surgery. Challenges involve limited space, fragile tissues, and the risk of iatrogenic injury. Potential complications include vascular laceration, organ injury, and postoperative ischemia. This activity for healthcare professionals is designed to hone learners’ skills in performing the Mattox maneuver and evaluating potential candidates. Participants will gain deeper insights into the relevant anatomy, as well as the procedure’s indications, contraindications, required preparation, proper technique, and possible complications. Improved mastery will empower clinicians to participate effectively in the interprofessional management of life-threatening retroperitoneal injuries.

Credit & MOC Details

Credit information is provided by the course provider. We recommend confirming credit eligibility with the provider or your licensing board before starting the activity.