Interventional Imaging in Pediatric Abdominal Trauma
The most common form of treatment of abdominal injuries in children is conservative, and it depends on the child’s response to initial resuscitation. However, a small percentage of children with blunt abdominal trauma may be nonresponsive to blood and fluid resuscitation due to significant injury with continuous internal bleeding. Such a patient requires emergent surgical or interventional radiology intervention to prevent hemorrhagic shock. Surgical exploration of unknown bleeding point could become even lengthier if the injury requires repair. This is not desirable in the aforementioned clinical scenario. Here comes the role of angiography and selective transarterial embolization/stenting in “damage control” and salvaging the patient. Thus in the acute bleeding, interventional radiology may help to control the hemorrhage or reestablish blood flow by using stents. In elective setting, it can help percutaneous stenting and drainage of urinary and biliary systems. Interventional radiology can also come as a rescue in the management of delayed complications of trauma, e.g., fistulas or pseudoaneurysms [1, 2].