Current strategy for hollow viscus injury with active bleeding: A case report
| Autor: | Youhei Tsubouchi, Keiji Sakurai, Hiroyuki Otsuka, Tomokazu Fukushima, Sadaki Inokuchi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Interventional radiology
Stomach injury lcsh:R5-920 medicine.medical_specialty medicine.diagnostic_test business.industry Case Report 030208 emergency & critical care medicine General Medicine stomach injury hemodynamic instability 03 medical and health sciences trauma 0302 clinical medicine 030220 oncology & carcinogenesis medicine Hollow viscus Radiology lcsh:Medicine (General) business Hemodynamic instability |
| Zdroj: | SAGE Open Medical Case Reports SAGE Open Medical Case Reports, Vol 7 (2019) |
| ISSN: | 2050-313X |
| DOI: | 10.1177/2050313x18824816 |
| Popis: | Despite rapid advancements in medical technologies, the use of interventional radiology in a patient with hemodynamic instability or hollow viscus injury remains controversial. Here, we discuss important aspects regarding the use of interventional radiology for such patients. A 74-year-old Japanese male climber was injured following a 10 m fall. On admission, his systolic blood pressure was 40 mmHg. He had disturbance of consciousness and mild upper abdominal pain without peritoneal irritation. Focused assessment sonography for trauma indicated massive hemorrhage in the intra-abdominal cavity. Plain radiographs revealed hemopneumothorax with right-side rib fractures. Thoracostomy to the right thoracic cavity and massive transfusion were immediately performed. Consequently, a sheath catheter was inserted into the common femoral artery for interventional radiology. His systolic blood pressure increased to 80 mmHg owing to rapid transfusion. In the computed tomography scan room, based on computed tomography findings, we judged that it was possible to achieve hemostasis by interventional radiology. The time from hospital admission to entering the angiography suite was 38 min. Transcatheter arterial embolization for hemorrhage control was performed without complications. Following transcatheter arterial embolization, he was admitted to the intensive care unit. All injuries could be treated conservatively without surgery. His post-interventional course was uneventful, and he recovered completely after rehabilitation. Hemorrhage control using interventional radiology should be assessed as a first-line treatment, even in hemodynamically unstable patients having a hollow viscus injury with active bleeding, without obvious findings that indicate surgical repair. |
| Databáze: | OpenAIRE |
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