title: Arterial Embolization in the Management of Mesenteric Bleeding Secondary to Blunt Abdominal Trauma.
abstract: BACKGROUND
  Mesenteric bleeding is a rare but potentially life-threatening complication of blunt abdominal trauma. It can induce active hemorrhage and a compressive hematoma leading to bowel ischemia. Emergency laparotomy remains the gold standard treatment. We aimed to study the effectiveness and complications of embolization in patients with post-traumatic mesenteric bleeding.
  
  
  METHODS
  The medical records of 7 consecutive patients with active mesenteric bleeding treated by embolization in a level-one trauma center from 2007 to 2014 were retrospectively reviewed. All patients presented with active mesenteric bleeding on CT scans without major signs of intestinal ischemia. We focused on technical success, clinical success, and the complications of embolization.
  
  
  RESULTS
  Six endovascular procedures were successful in controlling hemorrhage but 1 patient had surgery to stop associated arterial and venous bleeding. One patient suffered from bowel ischemia, a major complication of embolization, which was confirmed by surgery. No acute renal failure was noted after angiography. For 1 patient we performed combined management as the endovascular approach allowed an easier surgical exploration.
  
  
  CONCLUSIONS
  In mesenteric trauma with active bleeding, embolization is a valuable alternative to surgery and should be considered, taking into account the risk of bowel ischemia.
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France. JGhelfi@chu-grenoble.fr.
authors.forename: Julien
authors.initials: J
authors.lastname: Ghelfi
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Julien
authors.initials: J
authors.lastname: Frandon
authors.affiliation: Clinique Universitaire de Chirurgie Digestive et d'Urgences, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Sandrine
authors.initials: S
authors.lastname: Barbois
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Anne
authors.initials: A
authors.lastname: Vendrell
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Rodiere
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Christian
authors.initials: C
authors.lastname: Sengel
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Ivan
authors.initials: I
authors.lastname: Bricault
authors.affiliation: Clinique Universitaire de Chirurgie Digestive et d'Urgences, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Arvieux
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Gilbert
authors.initials: G
authors.lastname: Ferretti
authors.affiliation: Clinique Universitaire de Radiologie et Imagerie Médicale, CHU de Grenoble, BP 217, 38043, Grenoble Cedex 09, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Thony
mesh_terms: D000007:Abdominal Injuries / Q000150:complications*; D000328:Adult; D000368:Aged; D000792:Angiography; D004621:Embolization, Therapeutic / Q000379:methods*; D057510:Endovascular Procedures; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging; D008643:Mesentery / Q000098:blood supply* / Q000000981:diagnostic imaging; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications*
keywords: Artery; Bleeding; Embolization; Mesenteric injury; Trauma