title: The investigation of posttraumatic pseudoaneurysms in patients treated with nonoperative management for blunt abdominal solid organ injuries.
abstract: BACKGROUND
  Posttraumatic pseudoaneurysms (PAs) have been recognized as the cause of delayed hemorrhage complicated with nonoperative management (NOM), although the need for intervention in patients with small-sized PAs and the relationship between the occurrence of PAs and bed-rest has been also unclear.
  
  
  OBJECTIVE
  The purpose of this study was to investigate the clinical history of small-sized PAs (less than 10 mm in diameter) which occurred in abdominal solid organs, and to analyze the relationship between the occurrence of PAs and early mobilization from bed.
  
  
  METHODS
  Sixty-two patients who were successfully managed with NOM were investigated. Mobilization within three days post-injury was defined as "early mobilization" and bed-rest lasting over three days was defined as "late mobilization." A comparison of the clinical factors, including the duration of bed-rest between patients with and without PAs detected by follow-up CT was performed. Furthermore, a multiple logistic regression model analysis on the occurrence of PAs was performed.
  
  
  RESULTS
  PAs were detected in 7 of the 62 patients. The One patient with PAs measuring larger than 10 mm received trans-arterial embolization, and the remaining six patients with PAs smaller than 10 mm were managed conservatively. Consequently, no delayed hemorrhage occurred, and the PAs spontaneously disappeared in all of the six patients managed without intervention. The multiple regression model analysis revealed that early mobilization was not a significant factor predicting new-onset PAs.
  
  
  CONCLUSIONS
  Small PAs can be expected to disappear spontaneously. Moreover, early mobilization is not a significant risk factor for the occurrence of PAs.
authors.affiliation: Department of Emergency, Osaka Misihima Emergency Critical Care Center, 11-1, Minami-Akutagawa-cho, Takatsuki City, Osaka Prefecture, Japan.
authors.forename: Hirotada
authors.initials: H
authors.lastname: Kittaka
authors.affiliation: Department of Emergency, Osaka Misihima Emergency Critical Care Center, 11-1, Minami-Akutagawa-cho, Takatsuki City, Osaka Prefecture, Japan.
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Yagi
authors.affiliation: Department of Emergency, Osaka Misihima Emergency Critical Care Center, 11-1, Minami-Akutagawa-cho, Takatsuki City, Osaka Prefecture, Japan.
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Zushi
authors.affiliation: Department of Emergency, Osaka Misihima Emergency Critical Care Center, 11-1, Minami-Akutagawa-cho, Takatsuki City, Osaka Prefecture, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Hazui
authors.affiliation: Department of Emergency, Osaka Misihima Emergency Critical Care Center, 11-1, Minami-Akutagawa-cho, Takatsuki City, Osaka Prefecture, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Akimoto
mesh_terms: D000007:Abdominal Injuries / Q000150:complications / Q000473:pathology / Q000628:therapy*; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017541:Aneurysm, False / Q000209:etiology / Q000473:pathology / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014949:Wounds, Nonpenetrating / Q000150:complications / Q000473:pathology / Q000628:therapy*