Usefulness of emergency transcatheter arterial embolization in the arterial liver hemorrhages
Year 2005,
Volume: 36 Issue: 3, 133 - 136, 01.04.2005
Savaş Demirbilek
Ramazan Kutlu
Abstract
The prevalence of liver injury in patients who sustained blund multipl trauma was reported to range from 18%. Because previous mortality rates were as high as 50-80% for severe hepatic injury, the choice of treatment was under investigation. Whereas nonsurgical treatment fort he hemodinamically stable patient, there is no consensus on how to treat hemodinamically unstable patients. This report details the case of a patient who sustained blunt abdomianal trauma, resulting grade IV liver injury. Patient was hemodinamically unstable and emergency transcatheter arterial embolization was done to left hepatic arteria. We proposed that emergency transcatheter arterial embolization should be considered initial treatment for severe blunt hepatic injury in children.
References
- Cogbill TH, Moore EE, Jurkovich GJ, Feliciano
DV, Morris JM, Mucha P. Severe hepatic trauma: a
multicenter experience with 135 liver injuries. J
Trauma 1988, 28:1433-1438
- Ramenofosky ML. Infants and children as
accident victims and their emergency management
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Pediatric Surgery. St Louis, MO, Mosby Year-Book,
pp 235-243
Losty PD, Okoye BO, Walter DP, et al
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J Surg 1997; 84:1006-1008
- Shin H, TepasJJ III, IsmailmN, et al. Blunt hepatic
injury in adolescents: agemakes a difference. 1997;
Am Surg 63:29-36
- Malhotra Ak, Fabian TC, Croce MA, et al. Blunt
hepatic injury: a paradigm shift from operative to
nonoperative management in the 1990s. 2000;
Ann Surg 231:804-813
- Karp MP, Cooney DR, Pros GA, et al. The
nonoperative management of pediatric hepatic
trauma. J Pediatr Surg 1983; 18:512-518
- Brasel KJ, Deüsle CM, Olson CJ, et al. Trends in
the management of hepatic injury. Am J Surg 1997;
174:674-677
- Shilyansky J, Novarro O, Superina RA, et al
- Delayed hemorrhage after nonoperative
management of blunt hepatic trauma in children:
a rare but significant event. J Pediatr Surg 1999;
34:60-64
- Stylianos S. Evidence-based quidelines for
resource utilazation in children with isolated spleen
or liver injury. J Pediatr Surg 2000; 35:164-169
- Jander HP, Laws HL, Kogutt MS, et all
- Emergency embolization in blunt hepatic trauma
- AJR 1977; 129:249-252
- Sclafani SJA, Nayaranaswamy T, Mitchell WG
Radiaological management of traumatic hepatic
artery-portal vein arteriovenous fistulae. J Trauma
1981; 21:576-580
- Hidalgo F, Narvaez JA, Rene M, et al. Treatment
of hemobilia with selective hepatic artery
embolization JVIR 1995; 6:793-798
- Corr P, Beningfield SJ, Krige JE. Selective hepatic
artery embolization in complex liver injury. 1992;
23:347-349
- Sclafani S, Shaftan GW, Mc Auley J, et al
Interventional radiology in the management of
hepatic trauma. J Trauma 1984; 24:256-262
- Sugimoto K, Horoiike S, Hirata M, et al.The
role of angiography in the assessment of blunt liver
injury. Injury 1994; 25:283-287
- Pachter HL, Knudson MM, Esrig B, et al. Status
of nonoperative management of blunt hepatic
injuries in 1995: a multicenter experience with 404
patients. J Trauma 1996; 40:31-38
- Ohtsuka Y, Iwasaki K, Okazumi S, et al
- Management of blunt hepatic injury in children:
usefulness of emergecy transcathater arterial
embolization. Pediatr Surg Int 2003; 19:29-34
- Schwartz RA, Teitelbalum GP, Katz MD, et al
- Effectiviness of transcatheter embolization in
conttrol of hepatic vascular injuries. JVIR 1993;
4:359-365
Arteryal karaciğer kanamalarında acil transkateteryal arteryal embolizasyonun yararlılığı
Year 2005,
Volume: 36 Issue: 3, 133 - 136, 01.04.2005
Savaş Demirbilek
Ramazan Kutlu
Abstract
Abdominal künt multipl travmaya maruz kalan hastalarda karaciğer hasarı gelişme şansı %1 ila %8 olarak bildirilmiştir. Ciddi karaciğer yaralanmalarında mortalite oranları cerrahi ile %50-80 gibi yüksek değerlere ulaşabildiğinden, ideal tedavi seçeneği halen araştırılmaktadır. Noncerrahi tedavi hemodinamik olarak stabil hastalarda standart tedavi seçeneği iken, stabil olmayan hastalarda tedavi konusunda tam bir görüş birliği bulunmamaktadır. Bu raporda künt karın travması sonrasında evre IV karaciğer hasarlı, hemodinamik olarak stabil durumda olmayan çocuk hastamızda uygulanan acil transkateteryel sağ hepatik arter embolizasyonu sunulmuştur. Acil transkateteryel hepatik arter embolizasyonun ciddi karaciğer hasarlı olgularda ilk tedavi seçeneklerinden biri olabileceği düşünülmüştür.
References
- Cogbill TH, Moore EE, Jurkovich GJ, Feliciano
DV, Morris JM, Mucha P. Severe hepatic trauma: a
multicenter experience with 135 liver injuries. J
Trauma 1988, 28:1433-1438
- Ramenofosky ML. Infants and children as
accident victims and their emergency management
- In O2 Neill JA, Rowe MI, Grosfeld JL, et al (eds)
Pediatric Surgery. St Louis, MO, Mosby Year-Book,
pp 235-243
Losty PD, Okoye BO, Walter DP, et al
- Management of blunt liver trauma in children. Br
J Surg 1997; 84:1006-1008
- Shin H, TepasJJ III, IsmailmN, et al. Blunt hepatic
injury in adolescents: agemakes a difference. 1997;
Am Surg 63:29-36
- Malhotra Ak, Fabian TC, Croce MA, et al. Blunt
hepatic injury: a paradigm shift from operative to
nonoperative management in the 1990s. 2000;
Ann Surg 231:804-813
- Karp MP, Cooney DR, Pros GA, et al. The
nonoperative management of pediatric hepatic
trauma. J Pediatr Surg 1983; 18:512-518
- Brasel KJ, Deüsle CM, Olson CJ, et al. Trends in
the management of hepatic injury. Am J Surg 1997;
174:674-677
- Shilyansky J, Novarro O, Superina RA, et al
- Delayed hemorrhage after nonoperative
management of blunt hepatic trauma in children:
a rare but significant event. J Pediatr Surg 1999;
34:60-64
- Stylianos S. Evidence-based quidelines for
resource utilazation in children with isolated spleen
or liver injury. J Pediatr Surg 2000; 35:164-169
- Jander HP, Laws HL, Kogutt MS, et all
- Emergency embolization in blunt hepatic trauma
- AJR 1977; 129:249-252
- Sclafani SJA, Nayaranaswamy T, Mitchell WG
Radiaological management of traumatic hepatic
artery-portal vein arteriovenous fistulae. J Trauma
1981; 21:576-580
- Hidalgo F, Narvaez JA, Rene M, et al. Treatment
of hemobilia with selective hepatic artery
embolization JVIR 1995; 6:793-798
- Corr P, Beningfield SJ, Krige JE. Selective hepatic
artery embolization in complex liver injury. 1992;
23:347-349
- Sclafani S, Shaftan GW, Mc Auley J, et al
Interventional radiology in the management of
hepatic trauma. J Trauma 1984; 24:256-262
- Sugimoto K, Horoiike S, Hirata M, et al.The
role of angiography in the assessment of blunt liver
injury. Injury 1994; 25:283-287
- Pachter HL, Knudson MM, Esrig B, et al. Status
of nonoperative management of blunt hepatic
injuries in 1995: a multicenter experience with 404
patients. J Trauma 1996; 40:31-38
- Ohtsuka Y, Iwasaki K, Okazumi S, et al
- Management of blunt hepatic injury in children:
usefulness of emergecy transcathater arterial
embolization. Pediatr Surg Int 2003; 19:29-34
- Schwartz RA, Teitelbalum GP, Katz MD, et al
- Effectiviness of transcatheter embolization in
conttrol of hepatic vascular injuries. JVIR 1993;
4:359-365