[en] PURPOSE: To evaluate retrospectively the integrated diagnostic and therapeutic management of severely polytraumatized patients using a combined computed tomography (CT) and angiography suite with a single pivoting table. METHODS: Eleven patients, aged 16-74 years (median 30 years), were managed with spiral CT and angiography without patient transfer. Four patients were unstable, seven had received blood transfusions (2-18 units) and six were intubated. In 10 patients in whom active bleeding was demonstrated (splenic 5, hepatic 2, renal 2, left inferior epigastric artery 1), hemostatic embolization was obtained. RESULTS: Total procedure time did not exceed 80 min. Immediate hemostasis was achieved in all patients. Recurrent bleeding from the liver required additional embolization in one patient. Median length of stay in the intensive care unit was 4 days and median hospital stay was 27 days. All patients survived without significant sequelae. CONCLUSION: The use of a combined CT-angiography suite enables rapid diagnostic investigation and hemostatic embolization in actively bleeding trauma patients.
Disciplines :
Radiology, nuclear medicine & imaging
Author, co-author :
Kos, Xavier; Université de Liège - ULiège
Fanchamps, Jean-Marc; Université de Liège - ULiège
Trotteur, Geneviève ; Université de Liège - ULiège > Services généraux (Faculté de médecine) > Relations académiques et scientifiques (Médecine)
Dondelinger, Robert ; Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
Language :
English
Title :
Radiologic Damage Control: Evaluation of a Combined Ct and Angiography Suite with a Pivoting Table
Capasso P, Trotteur G, Flandroy P, Dondelinger RF (1996) A combined CT and angiography suite with a pivoting table. Radiology 199:561-563
Vanderschelden P, Flandroy P, Dondelinger RF, Martin D, Lenelle J (1998) Comparative evaluation of cerebral aneurysms with selective arterially enhanced CT and DSA. Eur Radiol 8:1181-1186
Mirvis SE, Whitley NO, Gens DR (1989) Blunt splenic trauma in adults: CT-based classification and correlation with prognosis and treatment. Radiology 171:33-39
Mirvis SE, Whitley NO, Vainwright JR, Gens DR (1989) Blunt hepatic trauma in adults: CT-based classification and correlation with prognosis and treatment. Radiology 171:27-32
Trunkey DD (1990) Priorities in trauma management. Milit Med 155: 217-219
Fisher RP, Berlin BC, Engrav LH, Benjamin CT, Perry JF (1979) Diagnostic peritoneal lavage: Fourteen years and 2586 patients later. Am J Surg 136:701-706
Shanmuganathan K, Sherbourne CD, Mirvis SE, Chiu WC, Chushing BM, Rodriguez A (1997) Hemoperitoneum as the sole indicator of visceral injury: A limitation of screening abdominal sonography for blunt trauma. Radiology 205(P): 192
Sclafani SJ, Shaftan GW, Scalea TM, Patterson LA, Kohl L, Kantor A, Herskowitz MM, Hoffer EK, Henry S, Dressner LS (1995) Nonoperative salvage of computed tomography-diagnosed splenic injuries: Utilization of angiography for triage and embolization for hemostasis. J Trauma 39:818-827
Dondelinger RF, Kurdziel JC (1991) A plea for conservative treatment without coeliotomy in hepatic contusions. Ann Chir 45:863-876
Ben-Menachem Y, Coldwell DM, Toung JW, Burgess AR (1991) Hemorrhage associated with pelvic fractures: Causes, diagnosis, and emergent management. AJR 157:1005-1014
Fisher RG, Ben-Menachem Y (1985) Embolization procedures in trauma: The abdomen - extraperitoneal. Semin Interv Radiol 2:148-157
