Traumatic mesenteric bleeding managed solely with transcatheter embolization.
We report a rare case of mesenteric bleeding following blunt abdominal trauma successfully treated solely with transcatheter arterial embolization (TAE) of the right colic marginal artery. A 56-year-old woman presented with mesenteric bleeding after being involved in a car accident. Computed tomography (CT) showed a large mesenteric hematoma and hemoperitoneum with no associated major injuries to other organs. There was a pseudoaneurysm with extravasation inside the hematoma. TAE was attempted to control bleeding during the preparation for surgical laparotomy. A superior mesenteric angiogram revealed a right colic marginal artery pseudoaneurysm. After successful TAE with microcoils, the affected colon perfusion was preserved via collateral circulation from the ileocolic artery. No ischemic gastrointestinal complications have occurred, and laparotomy has not been necessary during the 6 months after TAE. In isolated mesenteric injury cases, TAE may be a reasonable alternative to emergency laparotomy.
Kakizawa
Hideaki
H
Department of Radiology, Miyoshi Central Hospital, 531 Higashisakeya, Miyoshi, Hiroshima, 728-8502, Japan. kakizawa1234@hotmail.co.jp
Toyota
Naoyuki
N
Hieda
Masashi
M
Ishida
Makoto
M
Takeda
Taku
T
Matsuura
Kanji
K
Hirai
Nobuhiko
N
Tachikake
Toshihiro
T
Matsuura
Noriaki
N
Kohno
Shingo
S
Yananoue
Takao
T
Ito
Katsuhide
K
D000007:Abdominal Injuries / Q000150:complications; D000063:Accidents, Traffic; D004621:Embolization, Therapeutic / Q000379:methods*; D006406:Hematoma / Q000628:therapy; D006470:Hemorrhage / Q000628:therapy*; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000293:injuries*; D008875:Middle Aged; D014949:Wounds, Nonpenetrating / Q000150:complications