2.1.8 Conclusion
Trauma prevention and care does not attract the attention that it deserves. Research expenditures on trauma in Europe and the United States are very low in comparison with those of cancer or cardiovascular diseases; however, over the years modern medical imaging has become a cornerstone of management of trauma victims. Multislice CT is well established as an optimal screening modality for poly-trauma patients, provided the equipment is installed in emergency admissions and permanently operational. Although instantaneous imaging is able to detect the extend and severity of injuries, clinical symptoms and findings always take precedence in decision making on patient management. After reviewing the examination on the console, the radiologist should be able to formulate precisely the findings and should take part in the discussion on the clinical significance of the injuries observed and on management options, as long as arteriographic hemostatic embolization at admission is a considered an option
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References
Allison DJ, Jordon H, Hennessy O (1985) Therapeutic embolization of the hepatic artery: a review of 75 procedures. Lancet 1:595
Anderson R, Alwmark A, Gullstrand P, Offerbarti K, Bengmark S (1986) Non-operative treatment of blunt trauma to liver and spleen. Acta Chir Scand 152:739–741
Asensio JA, Demetriades D, Chahwan S et al. (2000) Approach to the management of complex hepatic injuries. J Trauma 48:66–69
Bass EM, Crosier JH (1977) Percutaneous control of posttraumatic hepatic hemorrhage by gelfoam embolization. J Trauma 17:61–63
Baum S, Roy R, Finkelstein AK, Blakemore WS (1965) Clinical applications of selective coeliac and superior mesenteric arteriography. Radiology 84:279–294
Beal SL (1990) Fatal hepatic hemorrhage: an unsolved problem in the management of complex liver injuries. J Trauma 30:163–169
Ben Menachem Y (1988) Pelvic fractures: diagnostic and therapeutic angiography: in Bassett FH (ed): Instructional course lectures. Park Ridge, Il: American Academy of Orthopaedic Surgeons 37:139–141
Ben Menachem Y, Bahramipour P (1997) Interventional radiologic damage control. Semin Intervent Radiol 14:151–162
Ben Menachem Y, Fisher RG, Ward RE (1981) Are “occult” intra-abdominal and extraperitoneal injuries really occult. Radiol Clin North Am 19:125–140
Ben Menachem Y, Handel SF, Ray RD, Childs TL (1985) Embolization procedures in trauma: a matter of urgency. Semin Intervent Radiol 2:107–117
Boijsen E, Judkins MP, Simay A (1966) Angiographic diagnosis of hepatic rupture. Radiology 86:66–72
Burgess AR, Eastridge BJ, Young JWR et al. (1990) Pelvic ring disruptions: effective classification system and treatment protocols. J Trauma 30:848–856
Capasso P, Trotteur G, Flandroy P, Dondelinger RF (1996) A combined CT and angiography suite with a pivoting table. Radiology 199:561–563
Chang J, Katzen BT, Sullivan KP (1978) Transcatheter gelfoam embolization of posttraumatic bleeding pseudoaneurysms. AJR 131:645–650
Chiu WC, Cushing BM, Rodriguez A et al. (1997) Abdominal injuries without hemoperitoneum: a potential limitation of focused abdominal sonography for trauma (FAST). J Trauma 42:817–822
Chuang VP, Reuter SR (1975) Selective arterial embolization for the control of traumatic splenic bleeding. Invest Radiol 10:18–24
Davis KA, Fabian TC, Croce MA et al. (1998) Improved success in non-operative management of blunt splenic injuries: embolization of splenic artery pseudoaneurysms. J Trauma 44:1008–1013
Deleuse P, Boverie JH, Ghaye B, Dondelinger RF (2001) Systematic CT evaluation of thoracic and abdominal blunt trauma: immediate vs delayed film reading. Eur Radiol (S) 11:144
Dondelinger RF, Kurdziel JC (1991) A plea for conservative nonoperative management of hepatic contusion. Ann Chir 45:863–876
Dondelinger RF, Trotteur G (2004) Hemostatic arterial embolization in blunt trauma victims at admission. In: Dondelinger RF (ed) Imaging and intervention in abdominal trauma. Springer, Berlin Heidelberg New York, pp 533–556
Dondelinger RF, Deleuse P, Ponghis G, Willems V (2004) Systematic CT examination of thoraco-abdominal trauma victims at admission. In: Dondelinger RF (ed) Imaging and intervention in abdominal trauma. Springer, Berlin Heidelberg New York, pp 504–512
Fankuchen EI, Martin EC, Karlson KB, Mattern RF, Casarella WJ (1981) Small coils for large hemorrhages. AJR 136:816–818
Federle MP (1983) Computed tomography of blunt abdominal trauma. Radiol Clin North Am 21:461–475
Federle MP, Crass RA, Jeffrey RB, Trunkey DD (1982) Computed tomography in blunt abdominal trauma. Arch Surg 117:645–650
Federle MP, Courcoulas AP, Powell M, Ferris JV, Peitzman AB (1998) Blunt splenic injury in adults: clinical and CT criteria for management, with emphasis on active extravasation. Radiology 206:137–142
Fisher RG, Ben-Menachem Y (1985) Embolization procedures in trauma: the extraperitoneal abdomen. Semin Intervent Radiol 2:148–157
Fisher RG, Foucar K, Estrada B, Ben-Menchem Y (1981) Splenic rupture in blunt trauma: correlation of angiographic and pathological records. Radiol Clin North Am 19:141–146
Fisher RG, Ben-Menachem Y, Wigham C (1989) Stab wounds of the renal artery branches: angiographic diagnosis and treatment by embolization. AJR 152:1231–1235
Freeark RJ, Love L, Baker RJ (1968) The role of aortography in the management of blunt abdominal trauma. J Trauma 8:557–571
Freeman T, Fischer RP (1976) The inadequacy of peritoneal lavage in diagnosing acute diaphragmatic rupture. J Trauma 16:538–540
Gavant ML, Schurr M, Frick PA et al. (1997) Predicting clinical outcome of nonsurgical management of blunt splenic injury: using CT to reveal abnormalities of splenic vasculature. AJR 168:207–211
Giraulo DL, Luk S, Palter M et al. (1998) Selective hepatic arterial embolization of grade IV and V blunt hepatic injuries: an extension of resuscitation in the nonoperative management of traumatic hepatic injuries. J Trauma 45:353–359
Gorich J, Rilinger N, Brado M et al. (1999) Non-operative management of arterial liver hemorrhages. Eur Radiol 9:85–88
Hagiwara A, Yukioka T, Shimazaki S, Megawa T, Matuda H (1993) Delayed hemorrhage following catheter arterial embolization for blunt hepatic injury. Cardiovasc Intervent Radiol 16:380–383
Hagiwara A, Yukioka T, Ohta S, Nitatori T, Matsuda N, Shimazaki S (1996) Nonsurgical management of patients with blunt splenic injury: efficacy of transcatheter arterial embolization. AJR 167:159–166
Hagiwara A, Yukioka T, Ohta S et al. (1997) Nonsurgical management of patients with blunt hepatic injury: efficacy of transcatheter arterial embolization. AJR 169:1151–1156
Harper HC III, Maull KI (2000) Transcatheter arterial embolization in blunt hepatic trauma. South Med J 93:663–665
Hashimoto S, Ido K, Hiramatsu K et al. (1990) Expanding role of emergency embolization in the management of severe blunt hepatic trauma. Cardiovasc Intervent Radiol 13:193–197
Hashimoto S, Hiramatsu K, Sato M (1997) CO2 as an intra-arterial digital subtraction angiography (IADSA) agent in the management of trauma. Semin Intervent Radiol 14:163–173
Hawkins IF, Caridi JG, Wiechmann BN, Kerns SR (1997) Carbon dioxide (CO2), digital subtraction angiography in trauma patients. Semin Intervent Radiol 14:175–180
Haydu P, Chang J, Knox G, Nealson TF Jr (1978) Transcatheter arterial embolization of a traumatic lumbar artery false aneurysm. Surgery 84:288–291
Hubbard SG, Bivins BA, Sachatello CR, Griffen WO Jr (1979) Diagnostic errors with peritoneal lavage in patients with pelvic fractures. Arch Surg 114:844–846
Jander HP, Russinovich AE (1980) Transcatheter gelfoam embolization in abdominal, retroperitoneal and pelvic hemorrhage. Radiology 136:337–344
Jander HP, Laws HL, Kogutt MS, Mihas AA (1977) Emergency embolization in blunt hepatic trauma. AJR 129:249–252
Katz MD, Teitelbaum GP, Pentecost MJ (1992) Diagnostic arteriography and therapeutic transcatheter embolization for posttraumatic pelvic hemorrhage. Semin Intervent Radiol 9:4–12
Keramidas DC (1979) The ligation of the splenic artery in the treatment of traumatic rupture of the spleen. Surgery 85:530–533
Killeen KL, Shanmuganathan K, Boydkranis R, Scalea TM, Mirvis SE (2001) CT findings after embolization for blunt splenic trauma. J Vasc Interv Radiol 12:209–214
Kos X, Fanchamps JM, Trotteur G, Dondelinger RF (1999) Radiologic damage control: evaluation of a combined CT and angiography suite with a pivoting table. Cardiovasc Intervent Radiol 22:124–129
Kurdziel JC, Dondelinger RF, Hemmer M (1987) Radiological management of blunt polytrauma with computed tomography and angiography: an integrated approach. Ann Radiol 30:121–124
Lang EK (1976) The role of arteriography in trauma. Radiol Clin N Am 14:353–370
Lang EK (1990) Intra-abdominal and retroperitoneal organ injuries diagnosed on computed tomograms obtained for assessment of renal trauma. J Trauma 30:1161–1168
Larsen DW, Pentecost MJ (1992) Embolotherapy in renal trauma. Semin Intervent Radiol 9:13–18
Love L, Greenfield GB, Braun TW, Moncada R, Freeark RJ, Baker RJ (1968) Arteriography in splenic trauma. Radiology 91:96–102
Matalon TSA, Athanasoulis CA, Margolies NM et al. (1979) Hemorrhage with pelvic fractures: efficacy of transcatheter embolization. AJR 133:859–864
Mears D (1980) External fixation of pelvic fractures. Orthop Clin North Am 11:465–479
Moore EE (1984) Critical decision making in the management of hepatic trauma. Am J Surg 6: 712–716
Murakami R, Tajima H, Kumazaki T (1993) Transcatheter hepatic arterial embolization for the treatment of blunt hepatic injury. Nippon Igaku Hoshasen Gakkai Zasshi 53:395–402
Mutabagani KH, Coley BD, Zumberge N et al. (1999) Preliminary experience with focused abdominal sonography for trauma (FAST) in children: Is it useful? J Pediatr Surg 34:48–52
Norell HG (1957) Traumatic rupture of the spleen diagnosed by abdominal aortography. Acta Radiol 48:449–452
Nunez LW, Simmons S, Kozar R, Kinback R, Hallowell MJ, Mulhern C Jr (2001) Feasibility and profitability of a radiology department providing trauma US as a part of a trauma alert team. Acad Radiol 8:88–95
Ochsner MG, Knudson MM, Pachter HL et al. (2000) Significance of minimal or no intraperitoneal fluid visible on CT scan associated with blunt liver and splenic injuries: a multicenter analysis. J Trauma 49:505–510
Panetta T, Sclafani SJA, Goldstein AS et al. (1985) Percutaneous transcatheter embolization for massive bleeding from pelvic fractures. J Trauma 25:1021–1029
Rao PM, Rhea JT, Novelline RA (1997) CT diagnosis of acute abdominal trauma. Semin Intervent Radiol 14:111–124
Richardson DJ, Franklin GA, Lukan JK et al. (2000) Evolution in the management of hepatic trauma: a 25-year perspective. Ann Surg 232:324–330
Rousseau H, Soula P, Perreault P et al. (1999) Delayed treatment of traumatic rupture of the thoracic aorta with endoluminal covered stent. Circulation 99:498–504
Rozycki GS, Ballard RB, Feliciano DV, Schmidt JA, Pennington SD (1998) Surgeon-performed ultrasound for the assessment of truncal injuries: lessons learned from 1540 patients. Ann Surg 228:557–567
Rubin BE, Katzen BT (1977) Selective hepatic artery embolization to control massive hepatic hemorrhage after trauma. AJR 129:253–256
Sato M, Fujisawa H, Hagiwara A et al. (1991) Traumatic hemorrhage of the spleen diagnosed by CO2 DSA. JJAAM 2:728–732
Scalea TM, Rodriguez A, Chiu WC et al. (1999) Focused assessment with sonography for trauma (FAST): results from an international consensus conference. J Trauma 46:466–472
Schwartz RA, Teitelbaum GP, Katz MD, Pentecost MJ (1993) Effectiveness of transcatheter embolization in the control of hepatic vascular injuries. J Vasc Interv Radiol 4:359–365
Sclafani SJA (1985) Angiographic control of intraperitoneal hemorrhage caused by injuries to the liver and spleen. Semin Intervent Radiol 2:139–147
Sclafani SJ, Shaftan GW, McAuley J et al. (1984) Interventional radiology in the management of hepatic trauma. J Trauma 24:256–262
Sclafani SJA, Weisberg A, Scalea TM, Philips TF, Duncan AO (1991) Blunt splenic injuries: nonsurgical treatment with CT, arteriography and transcatheter arterial embolization of the splenic artery. Radiology 181:189–196
Sclafani SJA, Shaftan GW, Scalea TM et al. (1995) Nonoperative salvage of computed tomography diagnosed splenic injuries: utilization of angiography for triage and embolization for hemostasis. J Trauma 39:818–825
Shanmuganathan K, Mirvis SE, Sover ER (1993) Value of contrast-enhanced CT in detecting active hemorrhage in patients with blunt abdominal or pelvic trauma. AJR 161:65–69
Shanmuganathan K, Mirvis SE, Boyd-Kranis R, Takada T, Scalea T (2000) Nonsurgical management of blunt splenic injury: use of CT criteria to select patients for splenic arteriography and potential endovascular therapy. Radiology 217:75–82
Sherman HF (1996) Letter to the editor. J Trauma 40:171
Sugimoto K, Horiike S, Hirata M, Ohwada T, Maekawa K (1994) The role of angiography in the assessment of blunt liver injury. Injury 25:283–287
Takakuwa T, Yokota J, Sugimoto T (1993) Liver infarction produced by dual vessels occlusion due to trauma and TAE: long follow up using CT, US and MRI. Med J Osaka Univ 41/42:23–27
Taylor GA, Sivit CJ (1995) Posttraumatic peritoneal fluid: Is it a reliable indicator of intraabdominal injury in children? J Pediatr Surg 30:1644–1648
Toma G de, Mingoli A, Modini C, Cavallaro A, Stipa S (1994) The value of angiography and selective hepatic artery embolization for continuous bleeding after surgery in liver trauma: case reports. J Trauma 37:508–511
Trunkey DD (1983) Trauma. Sci Am 249:28–35
Udekwu PO, Gurkin B, Oller DW (1996) The use of computed tomography in blunt abdominal injuries. Am Surg 62:56–59
Vogler E, Bergmann M (1963) Angiography in blunt kidney trauma. RöFo 98:675–685
Wagner WH, Lundell CJ, Donovan AJ (1985) Percutaneous angiographic embolization for hepatic arterial hemorrhage. Arch Surg 120:1241–1249
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Dondelinger, R.F., Trotteur, G., Ghaye, B. (2007). Hemostatic Arterial Embolization in Trauma Victims at Admission. In: Marincek, B., Dondelinger, R.F. (eds) Emergency Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68908-9_3
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