Ces radiol. 2012, 66(2):153-158

Acute endovascular procedures in the treatment of abdominal solid organ, retroperitoneal and pelvic injuriesOriginal article

Martin Köcher¹, Marie Černá¹, Stanislav Buřval¹, Igor Čižmář²

¹ Radiologická klinika LF a FN, Olomouc

² Traumatologické oddělení LF a FN, Olomouc

Background: Endovascular intervention is the current standard of practice to achieve hemostasis in blunt abdominal trauma. Percutaneous procedure comes after diagnostic CT examination, which is the most effective diagnostic tool to demonstrate active bleeding to the retroperitoneal space, pelvis and abdominal solid organs. The aim of the study is to evaluate endovascular treatment of abdominal solid organ, retroperitoneal and pelvic injuries.


Material and method. From 2008 to 2011 23 patients (17 men and 6 women) with traumatic bleeding from abdominal and retroperitoneal solid organs or pelvis were treated on Department of Radiology, University Hospital Olomouc. Indication for embolization was always active arterial bleeding detected on CT examination. Mean age of patients was 37.42 years (range 15-66 years). Coils and microcoils were the most frequently used embolic material.

Results: Endovascular treatment was definitive in 21 patients. Primary success rate was 91.3%. Reembolization for rebleeding was needed in two patients. Rebleeding is considered as major complication. No other major or minor complication for hemostatic embolization was seen in our cohort. Major complication rate was 8.7%.

Conclusion: Nonoperative management is nowadays preferred strategy of treatment in abdominal solid organ, retroperitoneal and pelvic injuries. Hemodynamically stable or by fluid infusions stabilised patients with active ongoing bleeding, arteriovenous or arterioportal fistula or pseudoaneurysm seen on CT are nowadays indicated for endovascular treatment.

Keywords: spleen, liver, kidney, pelvis, trauma, bleeding, embolization

Accepted: May 1, 2012; Published: June 1, 2012  Show citation