Gilyard Shenise, Shinn Kaitlin, Nezami Nariman, Findeiss Laura K, Dariushnia Sean, Grant April A, Hawkins C Matthew, Peters Gail L, Majdalany Bill S, Newsome Janice, Bercu Zachary L, Kokabi Nima
Division of Interventional Radiology and Image-Guided Medicine, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia.
Department of Medical Education, Emory University School of Medicine, Atlanta, Georgia.
Semin Intervent Radiol. 2020 Mar;37(1):35-43. doi: 10.1055/s-0039-3401838. Epub 2020 Mar 4.
Trauma remains one of the leading causes of death in the United States in patients younger than 45 years. Blunt trauma is most commonly a result of high-speed motor vehicular collisions or high-level fall. The liver and spleen are the most commonly injured organs, with the liver being the most commonly injured organ in adults and the spleen being the most affected in pediatric blunt trauma. Liver injuries incur a high level of morbidity and mortality mostly secondary to hemorrhage. Over the past 20 years, angiographic intervention has become a mainstay of treatment of hepatic trauma. As there is an increasing need for the interventional radiologists to embolize active hemorrhage in the setting of blunt and penetrating hepatic trauma, this article aims to review the current level of evidence and contemporary management of hepatic trauma from the perspective of interventional radiologists. Embolization techniques and associated outcome and complications are also reviewed.
在美国,创伤仍是45岁以下患者的主要死因之一。钝性创伤最常见于高速机动车碰撞或高处坠落。肝脏和脾脏是最常受伤的器官,肝脏是成人最常受伤的器官,而脾脏在儿童钝性创伤中受影响最大。肝损伤大多因出血导致较高的发病率和死亡率。在过去20年中,血管造影介入已成为肝创伤治疗的主要手段。由于介入放射科医生越来越需要在钝性和穿透性肝创伤情况下栓塞活动性出血,本文旨在从介入放射科医生的角度回顾肝创伤的当前证据水平和现代管理方法。还将回顾栓塞技术以及相关的结果和并发症。