Lessons learned in the management of thirteen celiac axis injuries.
OBJECTIVE
Celiac axis injuries are rare. The purposes of this study were to (1) review institutional experience, (2) determine additive effect on death of associated vessel injuries, and (3) correlate mortality rates with the American Association for the Surgery of Trauma-Organ Injury Scale (AAST-OIS) for abdominal vascular injury.


METHODS
This was a retrospective, 132-month study (January 1992 to December 2002) of patients with celiac axis injuries.


RESULTS
Thirteen patients were included in the study. Mean revised trauma score was 5.35+/-2.63; mean injury severity score was 25+/-12. The mechanism was penetrating in 12 (92%) and blunt in 1 (8%); 3 of 13 had Emergency Department thoracotomy (100% mortality rate). Treatment included ligation in 11 and primary repair in 1; 1 exsanguinated. Overall survival was 5 of 13 (38%). Adjusted survival excluding patients who had Emergency Department thoracotomy was 5 of 10 patients (50%). Those surviving with isolated injuries included 57% of patients. Mortality rate versus AAST-OIS was grade III, 43% (3 of 7 patients); grade IV, 50% (1 of 2 patients); and grade V, 100% (4 of 4 patients).


CONCLUSIONS
Celiac axis injuries are rare. Patients with isolated injuries have better survival rates. Mortality rate correlates well with AAST-OIS for abdominal vascular injury.
Asensio
Juan A
JA
Division of Trauma and Surgical Critical Care, Department of Surgery, University of Southern California Keck School of Medicine, Los Angeles County-University of Southern California Medical Center, Los Angeles, CA 90033-4525, USA. asensio@hsc.usc.edu
Petrone
Patrizio
P
Kimbrell
Brian
B
Kuncir
Eric
E
D002445:Celiac Artery / Q000293:injuries*; D006801:Humans; D012189:Retrospective Studies; D014947:Wounds and Injuries / Q000401:mortality / Q000601:surgery