Keywords:
Haemorrhage, Embolisation, CT, Emergency
Authors:
V. Miele1, G. L. Buquicchio1, I. Di Giampietro1, V. Di Giacomo1, G. Menichini2, M. Galluzzo3, S. Pieri4, M. Trinci5; 1Rome/IT, 2Roma/IT, 3Roma (RM)/IT, 4Roma /IT, 5Roma, ITALY/IT
DOI:
10.1594/ecr2013/C-1561
Methods and Materials
Between 9/2010 and 12/2012 773 patients with major trauma underwent a CT (Ultra16Lightspeed,
GE) examination in emergency department.
Before entering the CT suite,
each patients was assessed for vital signs,
pharmacologically stabilized,
sedated and provided with mechanical ventilation if spontaneous breathing was judged to be insufficient.
Peripheral venous acces with a needle cannula at least 18 gauge was performed to allow administration of intravenous contrast material.
The study protocol involved a baseline followed by
a biphasic study,
in the arterial phase for the chest and abdomen in the portal only for the abdomen,
after administration of 120-150 ml of contrast material at a concentration of 350mgI/ml (Iomeron 350,
Bracco,
Milano;Italia) with an automatic injector at a flow rate of 4-5 ml/s,
followed by 40ml of saline solution at a flow rate of 2 ml/s.
Pelvic fractures were present in 180/773 patients.
In pelvic fracture patients have searched the presence of pelvic hematoma: intra-or retroperitoneal and/or in the soft tissue (glutes,
adductors muscles).
We also searched the presence of active extravasation: during the early arterial phase,
the portal phase and near the stumps of bone fracture.
Angiography (Philips Integris 2000) was performed in 67 patients after CT detection of active bleeding or in case of not explained hemodynamic instability.