Early Detection of Arterial Bleeding in Acute Pelvic Trauma

Abstract

The finding of contrast extravasation on CECT is highly suggestive of significant arterial bleeding that requires early angiographic embolization to restore hemodynamic stability.

The role of endovascular treatment of pelvic fracture bleeding in emergency settings

“…The presence of extravasation of contrast materials on contrast-enhanced CT scans is highly predictive of arterial injury that will require angiographic embolisation. It has also been found to be a reliable indicator of arterial haemorrhage, with sensitivity of 66-90 %, specificity of 85-98 %, and accuracy of 87-98 % having been reported [18,19]. The detection of such extravasation on CT can lead to prompt angiographic embolisation, which can be life-saving.…”

Trauma radiology: The need for a teaching trauma case series

“…Correctly identifying injuries on CT in a timely manner is of utmost importance as it can significantly affect the early management a patient receives and thus their outcome [3,4]. Although on-the-job training provides invaluable learning experiences, reviewing cases in a safe environment within tutorials and through self-directed learning, is also necessary.…”

Penetrating trauma to the abdominal aorta: CT demonstration of active bleeding

“…The highest density clot, greater than 60 HU, is typically adjacent to the organ of injury. CT detection of active arterial hemorrhage has been well described in the literature and is likely to be increasingly frequently recognized with the deployment of ultrafast multidetector CT scanning using precisely timed contrast boluses [12,15,16,17,18,19,20,21,22,23,24]. When identified, the high density ªblushº of intra-arterial contrast indicates on-going hemorrhage and dictates immediate surgery or angiographic intervention [13,15].…”