Transcatheter arterial embolization for traumatic mesenteric bleeding: a 15-year, single-center experience

Shin, Jong Soo; Shin, Ji Hoon; Ko, Heung Kyu; Kim, Jong Woo; Yoon, Hyun Ki

doi:10.5152/dir.2016.15413

Cited by 17 publications

(14 citation statements)

References 28 publications

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“…It rapidly polymerizes with the blood, and therefore, it is advantageous for controlling massive hemorrhage that requires urgent hemostasis, especially in patients with coagulopathy. [7] In both our cases, successful embolization was achieved, and the patients were discharged without recurrent bleeding after embolization with NBCA. This result may be explained by 2 factors.…”

Section: Discussionmentioning

confidence: 55%

“…Embolization of the feeding artery was achieved using different combinations of embolic agents. [7] In our cases, NBCA was used as an embolic agent in both cases. The use of NBCA has recently gained acceptance.…”

Section: Discussionmentioning

confidence: 76%

“…Angiography can detect and localize the involved artery, and TAE can effectively stop acute bleeding with a lower morbidity and mortality than surgery. [7] Skilled interventional devices including microcatheter and embolic agents have increased the utility of TAE in various conditions. The choice of embolic agents is based on the vascular anatomy, angiographic findings, catheter position, and preferred operator.…”

Section: Discussionmentioning

confidence: 99%

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Pancreaticoduodenal arterial hemorrhage following blunt abdominal trauma treated with transcatheter arterial embolization

et al. 2020

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Rationale: Although surgery has been the standard treatment for pancreaticoduodenal trauma because of the complex anatomical relation of the affect organs, transcatheter arterial embolization (TAE) has recently been introduced as a safe and effective treatment. However, TAE for pancreaticoduodenal arterial hemorrhage (PDAH) can be challenging because it is difficult to localize the involved artery and to embolize the bleeding completely due to the abundant collateral channels of the pancreaticoduodenal artery (PDA). Patient concerns: Herein, we report 2 cases of PDAH that occurred after falling down in case 1 and a pedestrian traffic accident in case 2. Diagnoses: Multidetector computed tomography scan revealed massive retroperitoneal hematoma with active extravasation of contrast media from the PDA without any duodenal perforation or advanced pancreatic injury in both patients. Interventions: All patients were successfully treated using only TAE with a combination of microcoils and n -butyl cyanoacrylate (NBCA) in case 1, and only NBCA in case 2. Outcomes: There was no complication such as duodenal ischemia or pancreatitis. Laparotomy was not needed after TAE. Lessons: In selective PDAH cases, TAE may be a reasonable alternative to emergency laparotomy. It is expected that a careful and repetitive approach, based on complete angiography and embolization with a permanent liquid embolic agent such as NBCA could increase the success rate of TAE.

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Section: Discussionmentioning

confidence: 55%

Section: Discussionmentioning

confidence: 76%

Section: Discussionmentioning

confidence: 99%

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Pancreaticoduodenal arterial hemorrhage following blunt abdominal trauma treated with transcatheter arterial embolization

et al. 2020

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“…TAE is widely used to control traumatic bleeding as a hemostatic procedure and has been used in many situations. Recently, there are a number of reports that TAE is useful in the treatment of patients with mesenteric injuries [ [1] , [2] , [3] , [4] , [5] ]. TAE has the some of the advantages of surgical control of bleeding, and is also minimally invasive.…”

Section: Discussionmentioning

confidence: 99%

Transcatheter arterial embolization for initial hemostasis in a hemodynamically unstable patient with mesenteric hemorrhage: A case report

Nakama

Izawa

Kujirai

et al. 2019

Radiology Case Reports

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Surgical treatment of mesenteric injuries is necessary to control hemorrhage, manage bowel injuries, and evaluate bowel perfusion. It has recently been suggested that some patients can be managed with transcatheter arterial embolization (TAE) for initial hemostasis. We present a hemodynamically unstable patient who was initially managed by TAE for traumatic mesenteric hemorrhage. A 60-year-old man was injured in a motor vehicle accident and transported to our facility. On arrival, the patient was hemodynamically stable, and had abdominal pain. Physical examination revealed a seatbelt sign on the lower abdomen. A contrast-enhanced computed tomography (CT) scan showed intra-abdominal hemorrhage, mesenteric hematoma, and a giant-pseudoaneurysm, but no intra-abdominal free air or changes in the appearance of the bowel wall. After the CT scan, his vital signs deteriorated and surgical intervention was considered, but TAE was performed to control the hemorrhage. After TAE, the patient was hemodynamically stable and had no abdominal tenderness. A follow-up CT scan was performed 2 days later which showed partial necrosis of the transverse colon and some free air. Resection of the injured transverse colon with primary anastomosis was performed. The patient improved and was discharged 35 days after injury. TAE can be effective as the initial hemostatic procedure in patients with traumatic mesenteric hemorrhage.

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“…Mesenteric injuries can be associated with intestinal ischemia, intraperitoneal hemorrhage, or retroperitoneal hemorrhage, which can cause further injury to abdominal organs [5] . Transcatheter arterial embolization can be considered a treatment modality for mesenteric bleeding and has been shown to be as effective as open surgery in controlling intestinal hemorrhage [6] .…”

Section: Introductionmentioning

confidence: 99%

Angiographic management of the left hepatic artery disruption following motor vehicle accident

Dullet

Marshall

2017

Radiology Case Reports

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Transcatheter arterial embolization for traumatic mesenteric bleeding: a 15-year, single-center experience

Cited by 17 publications

References 28 publications

Pancreaticoduodenal arterial hemorrhage following blunt abdominal trauma treated with transcatheter arterial embolization

Pancreaticoduodenal arterial hemorrhage following blunt abdominal trauma treated with transcatheter arterial embolization

Transcatheter arterial embolization for initial hemostasis in a hemodynamically unstable patient with mesenteric hemorrhage: A case report

Angiographic management of the left hepatic artery disruption following motor vehicle accident

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