title: Treatment of intra-abdominal haemorrhagic shock by Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA).
abstract: OBJECTIVE
  Haemorrhagic shock is commonly encountered in the emergency room and is associated with high morbidity and mortality. For intra-thoracic and intra-abdominal bleeding, treatment usually requires either surgery or an interventional radiologic procedure. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has already been described for pelvic fractures and intra-abdominal haemorrhages. In this case report, we present the use of REBOA in a patient admitted for haemorrhagic shock due to a ruptured splenic artery aneurysm.
  
  
  METHODS
  We describe the case of a 35-year-old male with suspected massive pulmonary embolism. Prior to diagnostic confirmation by CT-scan, the patient suffered several cardiac arrests. CT-scan revealed a massive haemoperitoneum secondary to a ruptured aneurysm of the splenic artery. Because of refractory hypotension despite maximal conventional therapy, we used REBOA before patient transfer to the operating room for splenectomy.
  
  
  CONCLUSIONS
  This case underlines the feasibility of REBOA and discusses its role in uncontrollable intra-abdominal haemorrhagic shock.
authors.affiliation: Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: Louis
authors.initials: L
authors.lastname: Delamare
authors.affiliation: Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Crognier
authors.affiliation: Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Conil
authors.affiliation: Department of Radiology, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Rousseau
authors.affiliation: Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Georges
authors.affiliation: Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France. Electronic address: ruiz.stephanie@chu-toulouse.fr.
authors.forename: Stéphanie
authors.initials: S
authors.lastname: Ruiz
mesh_terms: D000328:Adult; D001011:Aorta; D001164:Arteriovenous Fistula / Q000150:complications; D021721:Balloon Occlusion / Q000379:methods*; D003128:Coma / Q000209:etiology; D015600:Glasgow Coma Scale; D006323:Heart Arrest / Q000209:etiology; D006465:Hemoperitoneum / Q000209:etiology; D006470:Hemorrhage / Q000150:complications; D006801:Humans; D008297:Male; D012151:Resuscitation / Q000379:methods*; D012771:Shock, Hemorrhagic / Q000628:therapy*; D013156:Splenectomy; D013157:Splenic Artery; D014057:Tomography, X-Ray Computed
keywords: Aneurysm; Haemoperitoneum; Haemorrhagic shock; Intra-aortic balloon occlusion; REBOA; Refractory shock