scholarly journals A case of non-occlusive mesenteric ischaemia caused by pelvic fracture due to fall trauma

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Yuichiro Furutani ◽  
Kaname Ishiguro ◽  
Masato Tokuraku ◽  
Hitoshi Moritomo
Keyword(s):  
Sigmoid Colon ◽  
Pelvic Fracture ◽  
Traumatic Injury ◽  
Arterial Embolization ◽  
Ascending Colon ◽  
Mesenteric Ischaemia ◽  
Intestinal Necrosis ◽  
Fall Injury ◽  
Internal Iliac ◽  
Traumatic Bleeding

Abstract Background Non-occlusive mesenteric ischaemia (NOMI) is a condition in which intestinal ischaemia arises due to spasms of peripheral blood vessels; however, there is no obstruction of the main arteries. Risk factors include hypertension, diabetes, and increasing age, but the traumatic injury triggering NOMI onset is rarely reported. We report a case of NOMI caused by a pelvic fracture due to a fall injury. Case presentation A 77-year-old man was transported to the hospital due to a fall injury. CT revealed a pelvic fracture and a haematoma in the pelvic extraperitoneal space. The next day, the patient developed shock, and CT revealed an increase in haematoma size. Both internal iliac arteries were embolized by transcatheter arterial embolization (TAE). The next day’s CT revealed intestinal necrosis of the ascending colon, and emergency surgery was planned. During surgery, necrosis was identified in the serosa of the ascending, transverse, and sigmoid colon. We performed subtotal excision from the ascending colon to the sigmoid colon. On postoperative day 10, melena was observed, and CT revealed partial thickening of the small intestine and a decrease in the contrast effect. Considering the post-total colectomy and general condition, we proceeded with conservative treatment. Over time, the patient developed liver and renal dysfunction and died 16 days after surgery. Conclusions We experienced a case of NOMI caused by bleeding from a pelvic fracture. It is important to keep in mind the risk of developing NOMI in traumatic bleeding to avoid missing this diagnosis.

scholarly journals Successful endovascular therapy in an elderly patient with severe hemorrhage caused by traumatic injury

Open Medicine ◽  
2018 ◽  
Vol 13 (1) ◽  
pp. 203-207
Author(s):  
Masato Murata ◽  
Makoto Aoki ◽  
Shuichi Hagiwara ◽  
Masao Sekihara ◽  
Takayuki Kohri ◽  
...  
Keyword(s):  
Traumatic Injury ◽  
Arterial Embolization ◽  
Severe Trauma ◽  
Aortic Injury ◽  
Multiple Rib Fractures ◽  
Intestinal Necrosis ◽  
Abdominal Aortic ◽  
Severe Hemorrhage ◽  
Internal Iliac ◽  
Enhanced Computed Tomography

AbstractAn 85-year-old female suffered pelvic fracture, multiple rib fractures, right hemopneumothorax, and blunt abdominal aortic injury in a traffic accident. After transfer to our hospital, transcatheter arterial embolization (TAE) was performed immediately for hemorrhage from the bilateral internal iliac arteries. Enhanced computed tomography (CT) after TAE showed an increase of hematoma and extravasation at the bifurcation of the abdominal aorta. Therefore, emergency abdominal endovascular aortic repair was performed on the same day. On the 3rd day after transfer, metabolic acidosis worsened suddenly, and enhanced CT revealed intestinal necrosis. Emergency surgery for the intestinal necrosis was performed. The patient was transferred to the previous hospital on the 31st day after transfer. Endovascular treatment is useful for elderly patients with severe trauma. However, the preservation and/or reconstruction of the blood flow to important organs should be monitored.

scholarly journals Superselective internal iliac arterial embolization for severe hemorrhage following radical prostatectomy

2012 ◽  
Vol 4 (3) ◽  
pp. 521-523 ◽  
Author(s):  
SHENG CHENG ◽  
LIWEI XU ◽  
GONGHUI LI ◽  
YUEBING CHEN ◽  
HONGJIE HU ◽  
...  
Keyword(s):  
Radical Prostatectomy ◽  
Arterial Embolization ◽  
Severe Hemorrhage ◽  
Internal Iliac

Effectiveness of Arterial Embolization in Hemodynamically Unstable Pelvic Fracture

2008 ◽  
Vol 20 (2) ◽  
pp. 117 ◽  
Author(s):  
Hyung Ku Yoon ◽  
Man Deuk Kim ◽  
Soo Hong Han ◽  
Byung Kuk Kim ◽  
Tae Keun Ahn
Keyword(s):  
Pelvic Fracture ◽  
Arterial Embolization ◽  
Unstable Pelvic Fracture

Hypogastric Arterial Embolization in Pelvic Fracture Hemorrhage

1990 ◽  
Vol 30 (11) ◽  
pp. 1417-1418 ◽  
Author(s):  
M. ASHRAF MANSOUR ◽  
FREDERICK A. MOORE ◽  
ERNEST E. MOORE
Keyword(s):  
Pelvic Fracture ◽  
Arterial Embolization

scholarly journals Endovascular Treatment of Mesenteric Ischaemia

2019 ◽  
Vol 9 (3) ◽  
pp. 239-241
Author(s):  
M. O. Loginov ◽  
L. S. Kokov ◽  
M. A. Nartaylakov ◽  
N. R. Chernaya ◽  
M. V. Loginova
Keyword(s):  
Endovascular Treatment ◽  
Clinical Case ◽  
Celiac Trunk ◽  
Transluminal Angioplasty ◽  
Mesenteric Arteries ◽  
Mesenteric Ischaemia ◽  
Visceral Arteries ◽  
Internal Iliac ◽  
Angioplasty And Stenting ◽  
Percutaneous Transluminal

Chronic mesenteric ischaemia constitutes a condition characterised by a decreased abdominal blood flow, which is caused by the obstruction of visceral arteries. This short communication paper presents a clinical case of endovascular treatment in a patient with the obstruction of the celiac trunk, superior and inferior mesenteric arteries. Intestinal blood supply was provided through collaterals from the system of internal iliac veins via the inferior mesenteric artery, the arc of Riolan. This clinical case confirmed that percutaneous transluminal angioplasty and stenting of the visceral arteries is the method of choice in the surgical treatment of abdominal angina.

Is It Beneficial to Optimize Vital Signs Before Embolization for Pelvic Fractures? A Dilemma Between Resuscitation and Hemostasis

2022 ◽  
pp. 000313482110651
Author(s):  
Ling-Wei Kuo ◽  
Chen-Yu Wang ◽  
Chien-An Liao ◽  
Yu-Tung Wu ◽  
Chien-Hung Liao ◽  
...  
Keyword(s):  
Blood Transfusion ◽  
Length Of Stay ◽  
Pelvic Fracture ◽  
Arterial Embolization ◽  
Hospital Length ◽  
Incidence Rates ◽  
Pelvic Fractures ◽  
Hospital Length Of Stay ◽  
Blood Transfusions ◽  
Icu Length Of Stay

Purpose Adequate resuscitation and definitive hemostasis are both important in the management of hemorrhage related to pelvic fracture. The goal of this study was to analyze the relationship between the amount of blood transfused before transcatheter arterial embolization (TAE) and the clinical outcome later in the disease course. Methods Patients with pelvic fractures who underwent TAE for hemostasis from January 2018 to December 2019 were studied. The characteristics of patients who received blood transfusions of >2 U (1000 mL) and ≤2 U before TAE were compared. The mortality rate, blood transfusion-related complications, and length of stay were compared between these two groups. Results Among the 75 studied patients, 39 (52.0%) received blood transfusions of ≤2 U before TAE, and the other 36 (48.0%) patients received blood transfusions of >2 U before TAE. The incidence rates of systemic inflammatory response syndrome, sepsis, and coagulopathy were significantly higher in the >2 U group (97.2% vs 81.1%, P = .027; 50.0% vs 27.0%, P = .045; and 44.4% vs 5.4%, P < .01, respectively). After nonsurvivors were excluded, the >2 U group had a significantly higher proportion (43.8% vs 14.7%, P < .001) of prolonged intensive care unit (ICU) length of stay (7 days or more) and a longer hospital length of stay (33.8 ± 15.1 vs 21.9 ± 94.0, P < .01) than the ≤2 U group. Pre-TAE blood transfusion >2 U serves as an independent risk factor for prolonged ICU length of stay and increased hospital length of stay. Conclusion Early hemostasis for pelvic fracture-related hemorrhage is suggested to prevent pre-TAE blood transfusion-associated adverse effects of blood transfusion.

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