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Case Report
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| Selective arterial embolization in hepatic trauma | ||||||
| Fred John1, Mary Rithu Varkey2 | ||||||
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1MBBS, R.M.O, Department of Internal Medicine, J.M.M.C & RI, India.
2MBBS, R.M.O, Department of Internal Medicine, S.R.M Hospital, India. | ||||||
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| How to cite this article |
| John F, Varkey MR. Selective arterial embolization in hepatic trauma. Int J Case Rep Images 2014;5(10):712–716. |
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Abstract
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Introduction:
Blunt abdominal trauma accounts for about (80%) of abdominal injuries seen in the emergency department. The spleen and liver are the most commonly injured solid organs in a blunt abdominal trauma. There has been a change in the trend towards the conservative management of liver injuries with improvement of the imaging techniques. Nowadays non-operative management has been preferred as the treatment of choice in hemodynamically stable cases of liver injuries. Transarterial embolization has been introduced as an effective tool for the management of hemodynamically stable patients with blunt hepatic trauma. This case illustrates the potential benefits of using hepatic artery embolization technique as a treatment modality in patients in whom active surgical intervention was not successful.
Case Report: A 21-year-old male presented to the emergency department with alleged history of fall from a building. On examination the patient was conscious and oriented, hypotensive, tachycardia and generalized abdominal tenderness. Focused assessment with sonography for trauma (FAST) was positive. So an emergency ultrasonography and contrast-enhanced computed tomography (CECT) scan of the abdomen were done which revealed gross hemoperitoneum with liver lacerations. Patient underwent an exploratory laparotomy, the surgeon was not able control the bleeding. So the patient was shifted to cath lab for an emergency hepatic artery embolization with gel foam. Bleeding was controlled with the procedure and he was discharged after two weeks. Conclusion: The non-operative management of blunt hepatic trauma is considered to be the gold standard care for hemodynamically stable patients. Since angiography can offer both diagnostic and therapeutic benefits, angiography should be considered in localizing the site of hemorrhage and in providing an opportunity for the interventional radiologist to proceed to transcatheter embolization of bleeding sites. | |
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Keywords:
Embolization, Hepatic trauma, Abdominal trauma, Liver
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Author Contributions
Fred John – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published Mary Rithu Varkey – Acquisition of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© 2014 Fred John et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information. |
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About The Authors
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