Background: Angiography is a common treatment used in adults with blunt abdominal trauma and/or severe pelvic fractures. The Committee on Trauma of the American College of Surgeons has recently advocated for this resource to be urgently available at pediatric trauma centers; however, its usefulness in the pediatric setting is unclear. The purpose of this study was to determine the incidence of angiography in the treatment of blunt abdominal trauma among injured children.
Methods: An analysis was performed using an established public use data set of children (younger than 18 years) treated at 20 participating trauma centers for blunt torso trauma through the Pediatric Emergency Care Applied Research Network. Patients who underwent angiography of the abdomen or pelvis were identified and analyzed.
Results: Of the 12,044 children evaluated for blunt abdominal trauma included within the data set, 973 sustained abdominopelvic injuries. Of these, only 26 (3%) underwent angiography. The median age was 14 years, 65% were males, with a mortality rate of 19%. Overall, 29 angiographic procedures were performed: 21 abdominal, 8 pelvic, with 3 patients undergoing both abdominal and pelvic. Eleven patients underwent embolization of a bleeding vessel, all of which were related to the spleen. No hepatic, renal, or pelvic vessels required embolization. The median time to angiography from emergency department evaluation was 7.3 hours. In addition to angiography, 50% also required surgical intervention, of which 31% underwent a laparotomy. Thirty-five percent of these patients required blood product transfusion, and 42% were admitted to the intensive care unit.
Conclusion: The emergent use of angiography with embolization is uncommon in pediatric patients with blunt abdominal injuries. The requirement that pediatric trauma centers have access to interventional radiology within 30 minutes may be unnecessary.
Level Of Evidence: Epidemiologic study, level III; therapeutic study, level IV.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1097/TA.0000000000001097 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Common Iliac Vein Injury Due to a Rectal Impalement Wound Treated Conservatively.
Am J Case Rep
December 2024
Department of Emergency and Critical Care Medicine, Nippon Medical School Musashi Kosugi Hospital, Kawasaki, Kanagawa, Japan.
BACKGROUND Iliac vein injuries usually require surgical intervention due to their high mortality rates. Although conservative management may be applicable in some cases of blunt trauma, the suitability of this approach for treating penetrating injuries remains underexplored. CASE REPORT A 51-year-old man sustained a common iliac vein injury following rectal impalement in a collapsing chair.
View Article and Find Full Text PDFCase Report: Life-saving embolization: a rare case of post-traumatic retroperitoneal hematoma from deep circumflex iliac artery rupture.
Front Surg
December 2024
Department of Radiology, Shaoxing Second Hospital, Shaoxing, Zhejiang, China.
Introduction: Retroperitoneal hematoma with ongoing hemorrhage is a rare but critical condition following blunt abdominal trauma, requiring urgent evaluation and management. This case details a large retroperitoneal hematoma in the right iliac fossa caused by a rupture of the deep circumflex iliac artery (DCIA), successfully treated with transcatheter arterial embolization.
Case Description: A 66-year-old female presented to our hospital six hours after an electric tricycle accident with dizziness, fatigue, hypotension (80/50 mmHg), and tachycardia (105 beats/min).
Herniated Gallbladder Following a Bull Run: A Case Report.
Cureus
November 2024
Surgery, Hospital de Santo Espírito da Ilha Terceira, Angra do Heroísmo, PRT.
The liver is the most common organ injury associated with blunt trauma. Blunt hepatic trauma, due to the high kinetic impact on the liver, causes compression and parenchymal disruption, leading to tears in its vascular structures. By contrast, gallbladder injury is rare because it is located beneath and shielded by the liver.
View Article and Find Full Text PDFDiaphragm injuries in a mature trauma system: still a diagnostic challenge.
Front Surg
December 2024
Department of Surgery, University Medical Centre Utrecht, Utrecht, Netherlands.
Background: A traumatic diaphragm defect is a rare injury. A missed diaphragm injury may cause serious morbidity and mortality. Detection rate during the first assessment of trauma patients is notoriously low.
View Article and Find Full Text PDFTraumatic abdominal wall hernia (TAWH) is a rare but serious condition resulting from blunt abdominal trauma, characterized by the herniation of bowel or abdominal organs through a disrupted musculature and fascia without skin penetration. This report describes a unique case of a 24-year-old man who sustained a high-velocity blunt abdominal injury from a motorcycle handlebar during a road traffic accident. The clinical presentation, diagnostic challenges, surgical intervention, and postoperative recovery are discussed to emphasize the importance of the early recognition and management of TAWH in trauma patients.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!