Endovascular Management of Lap Belt–Related Abdominal Aortic Injury in a 9-Year-Old Child

Papazoglou, Konstantinos; Karkos, Christos D.; Kalogirou, Thomas E.; Giagtzidis, Ioakeim T.

doi:10.1016/j.avsg.2014.09.026

Cited by 20 publications

(11 citation statements)

References 14 publications

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“…Blunt abdominal aortic injury is rare [61,62]. When it occurs, it is often associated with severe deceleration forces [63,64].…”

Section: Blunt Abdominal Aortic Traumamentioning

confidence: 98%

“…Concurrent injuries include lap belt injuries, Chance fractures, bowel injury, disruption of the cauda equina, and abdominal fascia disruption [65,66]. Endovascular management of children with blunt abdominal aortic trauma has been reported [61,64]. Advantages include avoiding operation or contamination in patients with concurrent bowel injury.…”

Section: Blunt Abdominal Aortic Traumamentioning

confidence: 99%

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Pediatric blunt abdominal trauma

Notrica

2015

Current Opinion in Critical Care

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“…Blunt abdominal aortic injury is rare [61,62]. When it occurs, it is often associated with severe deceleration forces [63,64].…”

Section: Blunt Abdominal Aortic Traumamentioning

confidence: 98%

Section: Blunt Abdominal Aortic Traumamentioning

confidence: 99%

Pediatric blunt abdominal trauma

Notrica

2015

Current Opinion in Critical Care

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“…Blunt aortic injuries with small intimal tears could be managed conservatively, with closely follow-up ( 36 – 43 ). In cases of large intimal flaps or free rupture, open ( 1 , 2 , 10 , 34 , 36 , 41 , 43 – 63 ) or endovascular repair are required ( 5 , 6 , 10 , 36 , 38 , 41 , 60 , 64 – 78 ) (Table 2 ).…”

Section: Diagnostic Evaluationmentioning

confidence: 99%

Contemporary Strategies in the Management of Civilian Abdominal Vascular Trauma

et al. 2018

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The evaluation and management of patients with abdominal vascular trauma or injury requires immediate and effective decision-making in these unfavorable circumstances. The majority of these patients arrive at trauma centers in profound shock, secondary to massive blood loss, which is often unrelenting. Moreover, ischemia, compartment syndrome, thrombosis, and embolization may also be life threatening and require immediate intervention. To minimize the risk of these potentially lethal complications, early understanding of the disease process and emergent therapeutic intervention are necessary. In the literature, the management of acute traumatic vascular injuries is restricted to traditional open surgical techniques. However, in penetrating injuries surgeons often face a potentially contaminated field, which renders the placement of prosthetic grafts inappropriate. Currently, however, there are sparse data on the management of vascular trauma with endovascular techniques. The role of endovascular technique in penetrating abdominal vascular trauma, which is almost always associated with severe active bleeding, is limited. It is worth mentioning that hybrid operating rooms with angiographic radiology capabilities offer more opportunities for the management of this kind of injuries by either temporary control of the devastating bleeding using endovascular balloon tamponade or with embolization and stenting. On the other hand, blunt abdominal injuries are less dangerous and they could be treated at most times by endovascular means. Since surgeons continue to encounter abdominal vascular trauma, open and endovascular techniques will evolve constantly giving us encouraging messages for the near future.

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“…As far as we know, there are no such cases of spontaneously occurring AD of Stanford type B in a child that were successfully treated by endovascular means. The literature includes a few cases of young patients who have recovered after endovascular treatment, but they involved traumatically caused iatrogenic AD [30][31][32][33][34][35]. In another reported case, of a 10-year-old child with AD after balloon angioplasty of a recoarctation, distal percutaneous membrane fenestration was performed [36].…”

Section: Discussionmentioning

confidence: 99%

Successful endovascular treatment of type B aortic dissection in a 15-year-old child

et al. 2017

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Disekce aorty je u dětské populace a u populace mladých dospělých vzácná [1]. V tomto článku popisujeme neobvyklý případ 15letého chlapce s náhlým nástupem bolesti na hrudi, bolesti zad spolu s necitlivostí levé dolní končetiny. Vyšetření výpočetní tomografi í hrudníku a oblasti břicha odhalilo disekci aorty typu B Stanford (typu III klasifi kace DeBakey) s výslednou subokluzivní stenózou horní mezenterické tepny (vyvolávající kritickou dysfunkci střev a ileus) a úplným uzávěrem levé iliacké a renální tepny. Pacient byl přijat v kritickém stavu 48 hodin po nástupu bolesti na hrudi. Po několika následných endovaskulárních výkonech bylo dosaženo revaskularizace a pacient byl propuštěn z nemocnice na základě příznivého klinického výsledku s úplnou obnovou průtoku krve tepnami cílových orgánů. Při první intervenci byly do horní mezenterické tepny a břišní tepny implantovány stenty, a byla provedena balonková dilatace levé iliacké tepny. Pro rezistentní renovaskulární hypertenzi byl o 20 dní později implantován stent do úplně uzavřené levé renální tepny; následně bylo dosaženo optimální úpravy krevního tlaku. O 33 dní později byl implantován stentgraft s cílem uzavřít primární trhlinu v hrudní tepně. Genetické vyšetření odebraných vzorků prokázalo mutaci v genu ACTA2. Tento případ je výjimečný tím, že se jednalo o život ohrožující postižení aorty současně s vaskulopatií, řešené poprvé endovaskulárně u dětského pacienta, a upozorňuje na možnost endovaskulární léčby u dětské populace. V článku popisujeme použití zobrazovacích metod, samotnou léčbu tohoto závažného onemocnění i její úspěšný výsledek.

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Endovascular Management of Lap Belt–Related Abdominal Aortic Injury in a 9-Year-Old Child

Cited by 20 publications

References 14 publications

Pediatric blunt abdominal trauma

Pediatric blunt abdominal trauma

Contemporary Strategies in the Management of Civilian Abdominal Vascular Trauma

Successful endovascular treatment of type B aortic dissection in a 15-year-old child

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