Rotenberg L, Tubiana J M, Porcel A, Bouras T, Monnier-Cholley L, Arrivé L
Service de Radiologie, Hôpital Saint-Antoine, PARIS.
Ann Radiol (Paris). 1996;39(2):89-103.
Interventional radiology used in acute abdominal diseases has demonstrated its efficacy in most emergency cases especially in patients at high risk for surgery. Percutaneous drainage is a reference standard for abscesses located within the abdomen and pelvis with high success rates of up to 80%. The diagnosis and treatment of gastrointestinal hemorrhage have changed over the past two decades, with decreased diagnostic examinations and advances in pharmacologic therapy and improved endoscopic techniques. On the other hand, embolization techniques and new procedures such as trans jugular intra hepatic porto systemic shunt have been developed. Arterial embolisation in many situations such as blunt or direct trauma, obstetric or post operative hemorrhage, can be used as an effective easy and relatively safe technique with high success rates to stop bleeding and save the organ. Percutaneous drainage and angiographic techniques adapted to biliary and urinary tree have also been developed as well as endoscopic procedures, allowing treatment of stenoses by balloon dilatation, or plastic or metal prostheses. Indications, technical aspects, complications and limits of these various procedures are presented.
介入放射学在急性腹部疾病中的应用已在大多数急诊病例中显示出其有效性，尤其是在手术风险高的患者中。经皮引流是腹部和盆腔脓肿的参考标准，成功率高达80%。在过去二十年中，胃肠道出血的诊断和治疗发生了变化，诊断检查减少，药物治疗取得进展，内镜技术得到改进。另一方面，栓塞技术和新的手术方法如经颈静脉肝内门体分流术已经得到发展。在许多情况下，如钝性或直接创伤、产科或术后出血，动脉栓塞可作为一种有效、简便且相对安全的技术，成功率高，可止血并挽救器官。适应于胆管和尿路的经皮引流和血管造影技术以及内镜手术也已得到发展，可通过球囊扩张、塑料或金属假体治疗狭窄。本文介绍了这些不同手术的适应症、技术方面、并发症和局限性。
