Angiographic Embolization Is Safe and Effective Therapy for Blunt Abdominal Solid Organ Injury in Children

Kiankhooy, Armin; Sartorelli, Kennith H.; Vane, Dennis W.; Bhave, Anant D.

doi:10.1097/ta.0b013e3181d3e5b7

Cited by 73 publications

(48 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…7Y11 Data in the pediatric population are scant, but early reports suggest that children with blunt splenic injury also gain increased splenic salvage through splenic artery embolization. 12,13 It is our hypothesis that the use of splenic artery embolization will offer an alternative to splenectomy after blunt splenic injury in children and an increased number of children will be able to preserve their spleen.…”

mentioning

confidence: 99%

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Gross

Woll

Hanson

et al. 2013

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

show abstract

mentioning

confidence: 99%

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Gross

Woll

Hanson

et al. 2013

Journal of Trauma and Acute Care Surgery

View full text Add to dashboard Cite

show abstract

“…The existing literature on AE as an adjunct treatment to paediatric liver injuries is limited to recent case series [25–27]. In our cohort, only two (3.0%) patients underwent AE, but the procedure was therapeutic in both cases and further transfusions and more invasive surgical procedures were thus avoided.…”

Section: Discussionmentioning

confidence: 91%

Surgical intervention for paediatric liver injuries is almost history - a 12-year cohort from a major Scandinavian trauma centre

Koyama

Skattum

Engelsen

et al. 2016

Scand J Trauma Resusc Emerg Med

View full text Add to dashboard Cite

BackgroundAlthough nonoperative management (NOM) has become standard care, optimal treatment of liver injuries in children is still challenging since many of these patients have multiple injuries. Moreover, the role of angiography remains poorly defined, and a high index of suspicion of complications is warranted. This study reviews treatment and outcomes in children with liver injuries at a major Scandinavian trauma centre over a 12-year period.MethodsPatients <17 years old with liver injury admitted to Oslo University Hospital Ullevaal during the period 2002-2013 were retrospectively reviewed. Data were compiled from the institutional trauma registry and medical records.ResultsA total of 66 children were included. The majority was severely injured as reflected by a median injury severity score of 20.5 (mean 22.2). NOM was attempted in 60 (90.9%) patients and was successful in 57, resulting in a NOM success rate of 95.0% [95% CI 89.3 to 100]. Only one of the three NOM failures was liver related, occurred in the early part of the study period, and consisted in operative placement of drains for bile leak. Two (3.0%) patients underwent angiographic embolization (AE). Complications occurred in 18 (27.3% [95 % CI 16.2 to 38.3]) patients. Only 2 (3.0%) patients had liver related complications, in both cases bile leak. Six (9.1%) patients underwent therapeutic laparotomy for non-liver related injuries. Two (3.0%) patients died secondary to traumatic brain injury.DiscussionThis single institution paediatric liver injury cohort confirms high attempted NOM and NOM success rates even in patients with high grade injuries and multiple accompanying injuries. AE can be a useful NOM adjunct in the treatment of paediatric liver injuries, but is seldom indicated. Moreover, bile leak is the most common liver-related complication and the need for liver-related surgery is very infrequent.ConclusionNOM is the treatment of choice in almost all liver injuries in children, with operative management and interventional radiology very infrequently indicated.

show abstract

“…Angiographic embolization for blunt solid organ injury has been utilized in the management algorithm for adults since the mid 1990s. Kiankhooy et al [11] reported 100% success rate of non-operative management in pediatric blunt hepatic injuries over five years at their institution. Of the 51 children with liver injuries, two underwent angiographic embolization for control of ongoing hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

Cardiopulmonary bypass after severe blunt hepatic injury: management of multi-system blunt trauma in an adolescent

Streit¹,

Kavarana²,

Scheurer³

et al. 2013

Journal of Pediatric Surgery

View full text Add to dashboard Cite

A 16-year-old adolescent male sustained combined injuries to the tricuspid valve and liver. This injury is exceptional due to the mechanism and the circumstances in which it took place: a flying pumpkin thrown from a sport utility vehicle. An echocardiogram demonstrated a flail chordal apparatus associated with the posterior leaflet of the tricuspid valve, creating substrate for severe tricuspid regurgitation with preserved right heart function. He was treated with non-operative management for the liver injury; he remained hemodynamically stable and was discharged home. He underwent successful repair of the tricuspid valve 17 days following the initial injury necessitating systemic anticoagulation and was discharged home two days later. The patient recovered fully without residual valvular pathology or hepatic sequelae.

show abstract

Angiographic Embolization Is Safe and Effective Therapy for Blunt Abdominal Solid Organ Injury in Children

Abstract: : AE is a safe and an effective technique for controlling hemorrhage from blunt ASO injuries in select pediatric patients.

Cited by 73 publications

References 19 publications

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Embolization for pediatric blunt splenic injury is an alternative to splenectomy when observation fails

Surgical intervention for paediatric liver injuries is almost history - a 12-year cohort from a major Scandinavian trauma centre

Cardiopulmonary bypass after severe blunt hepatic injury: management of multi-system blunt trauma in an adolescent

Contact Info

Product

Resources

About