The role of angiography in the assessment of blunt liver injury.
Angiography and therapeutic embolism (TE) were studied retrospectively in cases of blunt liver injury with regard to their indications and usefulness. The management of patients fell into three groups distinguished by the clinical evidence of the severity of the liver injuries. The most severe 42 cases (39.6 per cent) were managed surgically and promptly, the least severe 38 cases were not subjected to angiography and the intermediate group (26 cases; 24.5 per cent) underwent angiography and 12/26 cases underwent TE. However, haemodynamic stability on admission was not significantly different between these groups. In addition, all patients who underwent angiography and TE had more severe parenchymal injury on imaging studies while their haemodynamic instability was not identified on admission. Angiography and TE for blunt liver injury were most strongly indicated in patients with good haemodynamic responses to intravenous fluid administration during the acute phase and/or in cases of severe parenchymal injury on imaging.
Department of Traumatology and Critical Care Medicine, Kitasato University School of Medicine, Japan.
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K
Sugimoto
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Horiike
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M
Hirata
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T
Ohwada
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K
Maekawa
D000465:Algorithms; D015901:Angiography, Digital Subtraction; D004621:Embolization, Therapeutic; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006499:Hepatic Artery / Q000000981:diagnostic imaging*; D006801:Humans; D015601:Injury Severity Score; D008099:Liver / Q000293:injuries*; D016896:Treatment Outcome; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy