[Endovascular technologies in the treatment of patients with blunt abdominal trauma]. / Endovaskulyarnye tekhnologii v lechenii patsientov s zakrytoi travmoi organov bryushnoi polosti.

Trauma is one of the leading causes of disability and mortality in working-age population. Abdominal injuries comprise 20-30% of traumas. Uncontrolled bleeding is the main cause of death in 30-40% of patients. Among abdominal organs, spleen is most often damaged due to fragile structure and subcostal localization. In the last two decades, therapeutic management has become preferable in patients with abdominal trauma and stable hemodynamic parameters. In addition to clinical examination, standard laboratory tests and ultrasound, as well as contrast-enhanced CT of the abdomen should be included in diagnostic algorithm to identify all traumatic injuries and assess severity of abdominal damage. Development of interventional radiological technologies improved preservation of damaged organs. Endovascular embolization can be performed selectively according to indications (leakage, false aneurysm, arteriovenous anastomosis) and considered for severe damage to the liver and spleen, hemoperitoneum or severe polytrauma. Embolization is essential in complex treatment of traumatic vascular injuries of parenchymal abdominal organs. We reviewed modern principles and methods of intra-arterial embolization for the treatment of patients with traumatic injuries of the liver and spleen.

[EVOLUTION OF APPROACHES IN THE TREATMENT OF CLOSED INJURY OF THE LIVER AND SPLEEN].

The article analyzes the main aspects of the development of various approaches and methods in the provision of medical care to patients with closed abdominal trauma with damage to the liver and spleen. The most important stages of improving approaches, the impact of scientific and technological progress on the introduction of modern technologies in this area of surgery are described. The modern views of various authors on the existing problem are considered.