Schaverien Mark V, Evison Demetrius, McCulley Stephen J
Department of Plastic, Reconstructive and Burns Surgery, Nottingham City Hospital, Hucknall Road, Nottingham NG5 1PB, UK.
J Plast Reconstr Aesthet Surg. 2008;61(5):562-5; discussion 565. doi: 10.1016/j.bjps.2007.02.024. Epub 2007 Apr 25.
The incidence of radiographic contrast medium extravasation is on the rise due to the rapid increase in availability of contrast enhanced imaging. There is no consensus, however, regarding its management. There is a wide spectrum of clinical presentations, ranging from localised erythema and oedema to skin necrosis, which is related to the osmolarity and volume of the extravasated contrast medium. It is not possible to predict the degree of final tissue injury at initial examination. The increase in use of automated bolus injection has led to an increase in incidence of large volume extravasation injuries. Here we present a review of the literature regarding clinical presentation, risk factors, and management of contrast extravasation injuries. We also report the management of a large volume computed tomography contrast extravasation injury following mechanical bolus injection using a combination of liposuction and saline washout as described by Gault, and the use of compression by a Rhys-Davies exsanguinator as a technical refinement to achieve immediate resolution of the soft tissue oedema.
由于增强造影成像的可及性迅速增加，放射造影剂外渗的发生率正在上升。然而，关于其处理方法尚无共识。临床表现范围广泛，从局部红斑和水肿到皮肤坏死，这与外渗造影剂的渗透压和体积有关。在初次检查时无法预测最终组织损伤的程度。自动团注注射的使用增加导致了大量外渗损伤发生率的上升。在此，我们对关于造影剂外渗损伤的临床表现、危险因素及处理方法的文献进行综述。我们还报告了一例使用高特所述的抽脂术和盐水冲洗联合机械团注注射后发生的大量计算机断层扫描造影剂外渗损伤的处理情况，以及使用里斯 - 戴维斯放血器进行压迫作为一项技术改进以实现软组织水肿的即刻消退。
