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Title: Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma

Abstract

IntroductionMesenteric bleeding is a rare but potentially life-threatening complication of blunt abdominal trauma. It can induce active hemorrhage and a compressive hematoma leading to bowel ischemia. Emergency laparotomy remains the gold standard treatment. We aimed to study the effectiveness and complications of embolization in patients with post-traumatic mesenteric bleeding.Materials and MethodsThe medical records of 7 consecutive patients with active mesenteric bleeding treated by embolization in a level-one trauma center from 2007 to 2014 were retrospectively reviewed. All patients presented with active mesenteric bleeding on CT scans without major signs of intestinal ischemia. We focused on technical success, clinical success, and the complications of embolization.ResultsSix endovascular procedures were successful in controlling hemorrhage but 1 patient had surgery to stop associated arterial and venous bleeding. One patient suffered from bowel ischemia, a major complication of embolization, which was confirmed by surgery. No acute renal failure was noted after angiography. For 1 patient we performed combined management as the endovascular approach allowed an easier surgical exploration.ConclusionIn mesenteric trauma with active bleeding, embolization is a valuable alternative to surgery and should be considered, taking into account the risk of bowel ischemia.

Authors:
;  [1];  [2]; ; ; ;  [1];  [2]; ;  [1]
  1. CHU de Grenoble, Clinique Universitaire de Radiologie et Imagerie Médicale (France)
  2. CHU de Grenoble, Clinique Universitaire de Chirurgie Digestive et d’Urgences (France)
Publication Date:
OSTI Identifier:
22642530
Resource Type:
Journal Article
Resource Relation:
Journal Name: Cardiovascular and Interventional Radiology; Journal Volume: 39; Journal Issue: 5; Other Information: Copyright (c) 2016 Springer Science+Business Media New York and the Cardiovascular and Interventional Radiological Society of Europe (CIRSE); http://www.springer-ny.com; Country of input: International Atomic Energy Agency (IAEA)
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; BIOMEDICAL RADIOGRAPHY; BLOOD VESSELS; CAT SCANNING; GOLD; HAZARDS; HEMATOMAS; HEMORRHAGE; INJURIES; ISCHEMIA; KIDNEYS; MATERIALS; MEDICAL RECORDS; PATIENTS; POTENTIALS; REVIEWS; STANDARDS; SURGERY

Citation Formats

Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr, Frandon, Julien, E-mail: JFrandon2@chu-grenoble.fr, Barbois, Sandrine, E-mail: SBarbois@chu-grenoble.fr, Vendrell, Anne, E-mail: AVendrell@chu-grenoble.fr, Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr, Sengel, Christian, E-mail: CSengel@chu-grenoble.fr, Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr, Arvieux, Catherine, E-mail: CArvieux@chu-grenoble.fr, Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr, and Thony, Frédéric, E-mail: FThony@chu-grenoble.fr. Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma. United States: N. p., 2016. Web. doi:10.1007/S00270-015-1266-1.
Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr, Frandon, Julien, E-mail: JFrandon2@chu-grenoble.fr, Barbois, Sandrine, E-mail: SBarbois@chu-grenoble.fr, Vendrell, Anne, E-mail: AVendrell@chu-grenoble.fr, Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr, Sengel, Christian, E-mail: CSengel@chu-grenoble.fr, Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr, Arvieux, Catherine, E-mail: CArvieux@chu-grenoble.fr, Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr, & Thony, Frédéric, E-mail: FThony@chu-grenoble.fr. Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma. United States. doi:10.1007/S00270-015-1266-1.
Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr, Frandon, Julien, E-mail: JFrandon2@chu-grenoble.fr, Barbois, Sandrine, E-mail: SBarbois@chu-grenoble.fr, Vendrell, Anne, E-mail: AVendrell@chu-grenoble.fr, Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr, Sengel, Christian, E-mail: CSengel@chu-grenoble.fr, Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr, Arvieux, Catherine, E-mail: CArvieux@chu-grenoble.fr, Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr, and Thony, Frédéric, E-mail: FThony@chu-grenoble.fr. Sun . "Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma". United States. doi:10.1007/S00270-015-1266-1.
@article{osti_22642530,
title = {Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma},
author = {Ghelfi, Julien, E-mail: JGhelfi@chu-grenoble.fr and Frandon, Julien, E-mail: JFrandon2@chu-grenoble.fr and Barbois, Sandrine, E-mail: SBarbois@chu-grenoble.fr and Vendrell, Anne, E-mail: AVendrell@chu-grenoble.fr and Rodiere, Mathieu, E-mail: MRodiere@chu-grenoble.fr and Sengel, Christian, E-mail: CSengel@chu-grenoble.fr and Bricault, Ivan, E-mail: IBricault@chu-grenoble.fr and Arvieux, Catherine, E-mail: CArvieux@chu-grenoble.fr and Ferretti, Gilbert, E-mail: GFerretti@chu-grenoble.fr and Thony, Frédéric, E-mail: FThony@chu-grenoble.fr},
abstractNote = {IntroductionMesenteric bleeding is a rare but potentially life-threatening complication of blunt abdominal trauma. It can induce active hemorrhage and a compressive hematoma leading to bowel ischemia. Emergency laparotomy remains the gold standard treatment. We aimed to study the effectiveness and complications of embolization in patients with post-traumatic mesenteric bleeding.Materials and MethodsThe medical records of 7 consecutive patients with active mesenteric bleeding treated by embolization in a level-one trauma center from 2007 to 2014 were retrospectively reviewed. All patients presented with active mesenteric bleeding on CT scans without major signs of intestinal ischemia. We focused on technical success, clinical success, and the complications of embolization.ResultsSix endovascular procedures were successful in controlling hemorrhage but 1 patient had surgery to stop associated arterial and venous bleeding. One patient suffered from bowel ischemia, a major complication of embolization, which was confirmed by surgery. No acute renal failure was noted after angiography. For 1 patient we performed combined management as the endovascular approach allowed an easier surgical exploration.ConclusionIn mesenteric trauma with active bleeding, embolization is a valuable alternative to surgery and should be considered, taking into account the risk of bowel ischemia.},
doi = {10.1007/S00270-015-1266-1},
journal = {Cardiovascular and Interventional Radiology},
number = 5,
volume = 39,
place = {United States},
year = {Sun May 15 00:00:00 EDT 2016},
month = {Sun May 15 00:00:00 EDT 2016}
}