Abstract
Introduction
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.
Materials and Methods
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.
Results
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.
Conclusion
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.
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Julien Ghelfi, Julien Frandon, Sandrine Barbois, Anne Vendrell, Mathieu Rodiere, Christian Sengel, Ivan Bricault, Catherine Arvieux, Gilbert Ferretti, and Frédéric Thony have no conflict of interest.
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee (CECIC Rhône-Alpes-Auvergne, Clermont-Ferrand, IRB 5891) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Informed consent was obtained from all individual participants included in the study.
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Ghelfi, J., Frandon, J., Barbois, S. et al. Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma. Cardiovasc Intervent Radiol 39, 683–689 (2016). https://doi.org/10.1007/s00270-015-1266-1
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DOI: https://doi.org/10.1007/s00270-015-1266-1