Scientific PapersAngiographic embolization for arrest of bleeding after penetrating trauma to the abdomen
Section snippets
Patients and methods
All patients who underwent angiography for bleeding from intra-abdominal sites after penetrating trauma to the abdomen and back from January 1992 to May 1998 were included. The two body regions were defined by the nipple line and pubic symphysis anteriorly, and the tips of scapulae and gluteal folds posteriorly. Patients with penetrating injuries who had angiography for associated injuries of the extremities or neck, or for reasons not related directly to the anatomical injury (such as stress
Results
During the 77-month study period, 40 patients who were admitted for penetrating trauma to the abdomen and back underwent angiography for bleeding of abdominal or pelvic vessels. The characteristics of these patients are shown in Table I. The vessels embolized are described in Table II.
Group A included 6 patients who had angiography for bleeding as the first line of treatment. Angiography was performed on the basis of hematuria after injuries to the flank in 3, CT scan findings showing hepatic
Comments
To the best of our knowledge, this is the first series reported of patients who underwent angiography with the intent to arrest, by embolization, intra-abdominal bleeding caused by penetrating trauma. Although angiographic embolization has been widely used for blunt trauma,1, 2, 3 the published experience describing its use after penetrating trauma to the torso is limited to a few case reports.11, 12, 13 The belief that most penetrating injuries to the abdomen and back should be treated
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2015, International Journal of SurgeryCitation Excerpt :Blunt or penetrating injuries can easily result in life-threating post-traumatic hemorrhage from major vascular structures such as the pelvis, liver and kidneys, contributing to poor early outcomes. In such cases, an angiographic exploratory study becomes necessary for hemorrhage control in the radiology suite and also, to plan for potential imminent surgical interventions [11]. As non-operative management (NOM) of blunt abdominal trauma progressively takes precedence over surgical interventions, the role of AE has become all the more important [12].
The contemporary management of penetrating splenic injury
2014, InjuryCitation Excerpt :Delayed laparotomy (after 24 h) occurred in three patients but in no instance was this due to HVI or was a splenic procedure performed. Angiography is often advocated as an adjunct to blunt splenic trauma [23–26] and plays a prominent role in the NOM management of penetrating liver and renal injury [12,27,28]. Only one patient in our series underwent angiography.
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2012, Cirugia EspanolaUnstable patients with retroperitoneal vascular trauma: An endovascular approach
2011, Annals of Vascular SurgeryCitation Excerpt :This kind of surgical repair in hemodynamically unstable patients is associated with high mortality rates.2 The progress made in endovascular techniques over the last few decades has enabled us to achieve hemostasis safely and rapidly by using different means such as embolization, balloon occlusion, and stent-grafting.4,14-17 Progressively, these techniques have become a useful adjunct in the treatment of persistent or recurrent bleeding and have also been used as a primary therapeutic approach in selected patients.5
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