Blunt Hepatic Trauma: Evaluation With Contrast-Enhanced Sonography

Catalano, Orlando; Lobianco, Roberto; Raso, Mauro Mattace; Siani, Alfredo

doi:10.7863/jum.2005.24.3.299

Cited by 73 publications

(43 citation statements)

References 45 publications

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“…The employment of CEUS in abdominal traumas is still not defined. CEUS improves the visibility of traumatic lesions in the liver, spleen, and kidneys, allowing a better definition of lesion extension to the organ capsule, which is an important criterion for the surgical evaluation [86,87] and reveals the active post-traumatic Fig. 9 Focal renal perfusion defects.…”

Section: Application Of Ceus In Emergenciesmentioning

confidence: 99%

Microbubble ultrasound contrast agents: an update

2007

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Microbubble contrast agents for ultrasound (US) have gained increasing interest in recent years, and contrast-enhanced US (CEUS) is a rapidly evolving field with applications now extending far beyond the initial improvements achieved in Doppler US. This has been achieved as a result of the safe profile and the increased stability of microbubbles persisting in the bloodstream for several minutes, and also by the availability of specialized contrast-specific US techniques, which allow a definite improvement in the contrast resolution and suppression of signal from stationary tissues. CEUS with low transmit power allows real-time scanning with the possibility of prolonged organ insonation. Several reports have described the effectiveness of microbubble contrast agents in many clinical applications and particularly in the liver, spleen, and kidneys. CEUS allows the assessment of the macrovasculature and microvasculature in different parenchymas, the identification and characterization of hepatic and splenic lesions, the depiction of septal enhancement in cystic renal masses, and the quantification of organ perfusion by the quantitative analysis of the echo-signal intensity. Other fields of application include the assessment of abdominal organs after traumas and the assessment of vesico-ureteral reflux in children. Finally, tumor-targeted microbubbles make possible the depiction of specific biologic processes.

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Section: Application Of Ceus In Emergenciesmentioning

confidence: 99%

Microbubble ultrasound contrast agents: an update

2007

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“…In addition, it possess more advantages than other minimally invasive methods, considering its advanced properties and functions such as light, fast and wide accessibility, bedside applicability and shielding patients from the hazard of ionizing radiation. The literature [44][45][46] indicates that CEUS was effective in the diagnosis of blunt hepatic trauma, had similar performance to that of CT and was more sensitive than conventional sonography.…”

Section: Discussionmentioning

confidence: 99%

A novel hemostatic sealant composed of gelatin, transglutaminase and thrombin effectively controls liver trauma-induced bleeding in dogs

Xie

Tian

et al. 2013

Acta Pharmacol Sin

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Aim: A novel hemostatic sealant based on the in situ gel formation of gelatin catalyzed by thrombin and crosslinked by transglutaminase was designed. The aim of this study was to investigate the efficacy of the hemostatic sealant in control of bleeding caused by liver trauma in dogs. Methods: Hepatic trauma that mimicked the grade III-IV rupture of liver was made in 20 dogs. The traumatic lesion was topically administered the hemostatic sealant (treatment group, n=10), or a thrombin solution (control group, n=10). The time to achieve hemostasis and the blood loss were measured. Contrast-enhanced ultrasound (CEUS) examination was performed in each animal on d 3, d 7, and d 10 d postoperatively to study the healing of the lesions. Results: The mean time to achieve hemostasis in the treatment group was significantly shorter than that in the control group (1.20±0.33 vs 6.70±0.64 min, P<0.05). The mean blood loss in the treatment group was significantly less than that in the control group (47.22±8.61 vs 79.29±11.97 mL, P<0.05). In CEUS examination, the traumatic lesions in the treatment group became significantly smaller on d 3, and disappeared on d 7, whereas the lesions in the control group still existed on d 10. Ascites were never found during 10 d follow-up in the treatment group but were observed on d 3 and d 7 in the control group. Conclusion: Compared with thrombin, the novel hemostatic sealant shows much better efficacy in hemostasis and may promote wound healing in dog liver trauma.

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“…CES ascertained that liver was viable, and we attributed sepsis to bile leak. Utility of CES is also echoed in the literature as an important tool both in initial and delayed assessment of liver trauma patients [10]. We subjected the patient to ERCP and stenting, which relieved the patient of any further complications.…”

Section: Discussionmentioning

confidence: 99%

Massive Liver Trauma—Multidisciplinary Approach and Minimal Invasive Surgery can Salvage Patients

Thapar

Ghawat²,

Dalvi³

et al. 2012

Indian J Surg

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Management of massive liver trauma (grades IV-VI) is associated with high morbidity and mortality. It can pose serious challenges to treating physician and requires multimodality interventions. For a successful outcome, timing of intervention is crucial. We report a case of grade V hepatic injury treated successfully with angioembolization, laparoscopic lavage, and endoscopic stenting during a time period from admission to discharge on the 24th day. Angioembolization was performed at admission after resuscitation as CT scan showed active extravasation in the arterial phase. Laparoscopic lavage and drainage was performed on the fifth day as abdominal inflammatory response failed to respond to medical management. There was biliary component of abdominal fluid noticed during laparoscopy, which manifested by postoperative localized biliary fistula; hence endoscopic stenting of the bile duct was performed on the seventh day. The patient recovered well with timely minimal invasive approach and was fine at 1 year follow-up.

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Blunt Hepatic Trauma: Evaluation With Contrast-Enhanced Sonography

Cited by 73 publications

References 45 publications

Microbubble ultrasound contrast agents: an update

Microbubble ultrasound contrast agents: an update

A novel hemostatic sealant composed of gelatin, transglutaminase and thrombin effectively controls liver trauma-induced bleeding in dogs

Massive Liver Trauma—Multidisciplinary Approach and Minimal Invasive Surgery can Salvage Patients

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