Trauma and Emergency Center, China Medical University Hospital, Taichung, Taiwan.
Am J Emerg Med. 2011 Nov;29(9):1147-51. doi: 10.1016/j.ajem.2010.06.001. Epub 2010 Sep 25.
Our aim was to evaluate the clinical effectiveness of transcatheter arterial embolization (TAE) in the management of hemodynamically stable blunt hepatic trauma (BHT) patients with contrast material extravasation into the peritoneal cavity, known as type I contrast material extravasation, on computed tomography (CT) scan.
Adult patients who sustained BHT and who were hemodynamically stable after initial resuscitation underwent abdominal CT scan. If the abdominal CT scan revealed type I contrast material extravasation, patients who remained hemodynamically stable were sent for angiography.
During a 30-month period, 8 patients were identified with type I contrast material extravasation. Three received immediate celiotomy because of hemodynamic instability. Five patients received angiography and subsequent TAE. One patient received celiotomy after TAE. The success rate of TAE was 50% (4/8).
With TAE, nonoperative management of hemodynamically stable BHT patients with type I contrast material extravasation on CT scan was achieved in half patients.
我们的目的是评估经导管动脉栓塞术（TAE）在管理 CT 扫描显示腹腔内对比剂外渗（称为 I 型对比剂外渗）的血流动力学稳定的钝性肝外伤（BHT）患者中的临床效果。
对初始复苏后血流动力学稳定的成人 BHT 患者进行腹部 CT 扫描。如果腹部 CT 扫描显示 I 型对比剂外渗，且患者仍保持血流动力学稳定，则进行血管造影。
在 30 个月的时间内，发现 8 例 I 型对比剂外渗患者。其中 3 例因血流动力学不稳定而立即行剖腹术。5 例患者接受了血管造影和随后的 TAE。1 例患者在 TAE 后行剖腹术。TAE 的成功率为 50%（4/8）。
对于 CT 扫描显示 I 型对比剂外渗的血流动力学稳定的 BHT 患者，采用 TAE 可使一半患者实现非手术治疗。
