Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma
Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma
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DOI：
10.1007/s00270-015-1266-1
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发表时间：
2016-05-01
影响因子：
2.9
通讯作者：
Thony, Frederic
中科院分区：
文献类型：
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作者：
Ghelfi, Julien;Frandon, Julien;Thony, Frederic
肠系膜出血是一种罕见的，但可能危及生命的并发症钝性腹部创伤。它可以诱发活动性出血和压迫性血肿，导致肠缺血。紧急剖腹手术仍然是金标准治疗。为了研究栓塞治疗创伤后肠系膜出血的有效性和并发症，我们回顾性分析了2007年至2014年在一级创伤中心接受栓塞治疗的7例活动性肠系膜出血患者的病历。所有患者在CT扫描上均表现为活动性肠系膜出血，无肠缺血的主要体征。我们重点关注栓塞的技术成功率、临床成功率和并发症。6例血管内手术成功控制出血，但1例患者接受了手术以阻止相关的动脉和静脉出血。1例患者发生肠缺血，这是栓塞的主要并发症，经手术证实。血管造影后未发现急性肾功能衰竭。对于1例患者，我们进行了联合治疗，因为血管内方法允许更容易的手术探查。在肠系膜创伤伴活动性出血的情况下，栓塞是手术的一种有价值的替代方法，应考虑到肠缺血的风险。
Mesenteric 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.The 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.Six 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.In mesenteric trauma with active bleeding, embolization is a valuable alternative to surgery and should be considered, taking into account the risk of bowel ischemia.