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Emerg Radiol ; 28(1): 55-63, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32725601

RESUMO

PURPOSE: To evaluate the safety and effectiveness of transcatheter arterial embolization (TAE) in treating traumatic mesenteric injuries with active bleeding, to report the outcome in a case series, and to compare the results with the existing data. METHODS: All consecutive patients with active mesenteric bleeding due to blunt abdominal trauma referred to a level-one Trauma Center and treated by TAE were included; the related demographic and medical data were retrospectively reported. A literature review was conducted; all reported cases were collected and analysed together with our case series. A univariate analysis of risk factors for TAE failure, bowel necrosis, complication and length of stay was performed. RESULTS: Four consecutive patients were included. Technical success was 100%. One patient developed colon ischemia after the procedure and underwent surgical treatment; another presented transient mild renal failure and late respiratory failure. No 30-day mortality was reported. These results are consistent with those reported in literature. The analysis of our cases together with case collected from literature resulted in a case series of 25 patients. Univariate analysis showed colon as site of bleeding as a significant risk factor for bowel necrosis and older age as a significant risk factor for longer length of stay. TAE failure was not significantly associated neither with a higher complication rate nor with a higher length of stay. CONCLUSION: TAE is a safe and effective procedure to control mesenteric bleeding, thus should be considered, in selected cases and in appropriate setting, as an alternative to emergency surgery.


Assuntos
Traumatismos Abdominais/terapia , Angiografia por Tomografia Computadorizada , Embolização Terapêutica/métodos , Hemorragia/terapia , Artérias Mesentéricas/lesões , Ferimentos não Penetrantes/terapia , Traumatismos Abdominais/diagnóstico por imagem , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste , Feminino , Humanos , Escala de Gravidade do Ferimento , Iohexol/análogos & derivados , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Centros de Traumatologia , Falha de Tratamento , Ferimentos não Penetrantes/diagnóstico por imagem
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