Interventionell-radiologisches Management traumatischer Becken-, retroperitonealer und gastrointestinaler Blutungen
摘要
Embolization via interventional radiology (IR) plays a critical role in the management of trauma patients and is effective in controlling arterial hemorrhaging in the pelvis, retroperitoneum, and gastrointestinal tract.
ObjectiveTo evaluate the role of IR in the management of traumatic arterial bleeding in the pelvic, retroperitoneal and gastrointestinal regions.
Material and methodsA comprehensive literature review was conducted to assess the current evidence regarding the indications, procedural techniques and results of embolization following trauma in the named regions.
ResultsThe decision to perform embolization is determined individually and interdisciplinary based on contrast-enhanced computed tomography (CT). In cases of arterial bleeding, embolization following pelvic trauma is a key pillar of treatment. Posttraumatic retroperitoneal renal embolization is indicated as the method of choice in cases of traumatic arterial bleeding without devascularization or fragmentation of the kidney. Although there is a lack of robust data and clear guidelines for embolization in traumatic gastrointestinal and other retroperitoneal hemorrhages, evidence from nontraumatic cases suggests a high therapeutic potential. The endovascular techniques used in trauma closely mirror those employed in nontraumatic vascular occlusion interventions in these regions.
DiscussionTargeted embolization effectively controls traumatic bleeding.