Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma

Ingram, Michael; Siddharthan, Ragavan; Morris, Andrew D.; Hill, Sarah J.; Travers, Curtis; McKracken, Courtney E.; Heiss, Kurt F.; Raval, Mehul V.; Santore, Matthew T.

doi:10.1097/ta.0000000000001114

Cited by 31 publications

(22 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Only when the hemodynamic status of patients with a contrast blush on CT deteriorates is embolization indicated. This policy is in line with the literature that shows that in the presence of a contrast blush on CT, pediatric patients can be successfully treated withoutimmediate angio-embolization [29–31], which contrasts with a recent recommendation from Bhullar et al [16]. In our institution, an interventional radiologist is available 24 h a day and patients with splenic injuries are initially continuously monitored in the pediatric intermediate/intensive care unit.…”

Section: Discussionsupporting

confidence: 71%

Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma

et al. 2020

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 71%

Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma

et al. 2020

View full text Add to dashboard Cite

“…Total 15(19%) of the cases had needed surgical interventions in the form of laparatomies while 63(81%) were successfully managed with nonoperative conservative management that is within the range of worldwide data. [21][22][23][24][25] These results strongly advocates the effective role of nonoperative conservative management in most of the liver injuries in blunt abdominal trauma and hemodynamic stability of the injured cases is the key role in deciding between operative and non operative management.…”

Section: Discussionmentioning

confidence: 99%

Liver Injuries

Toor¹,

Memon²,

Leghari³

2018

TPMJ

View full text Add to dashboard Cite

Objectives: To determine the role (frequency) of non-operative conservative management in liver injuries in blunt abdominal trauma. Methodology:.. Study Design: Descriptive study. Setting: Department of surgery Peoples University of Medical & Health Sciences Nawabshah. Period: 36 months extending from august 2014 to July 2017. Patients & Methods: All Patients with abdominal blunt trauma underwent ABCD evaluation, primary survey, secondary survey and initial management/resuscitation as per needed. History, clinical examination, plain radiographs, ultrasound (FAST) and computerized tomography were used as diagnostic tools. Patients with isolated liver injuries in blunt abdominal trauma wereselected for the present study. Selected cases with hemodynamic instability, even after initial vigorous resuscitation had to undergoes immediate surgical abdominal exploration while the rest of the selected cases were hospitalized and kept under strict monitoring. The decisions of late surgical intervention were then made on deterioration of hemodynamic stability and rapid progression of liver injuries from lower grades to higher grades. Percentages of the cases managed conservatively and rest of others who required surgical interventions were noted. Data was analyzed on SPSS-21. Results: 78 cases were selected with mean age of 38 years & SD± 7. Male to female ratio was 5:1. 11% of the cases with hemodynamic unstability underwent immediate surgical intervention. 8% of the case underwent late surgical operative management after initial course of non operative conservative management. 81% cases were managed with successful non operative conservative approach. Conclusion: Most of the liver injuries in blunt abdominal trauma require non-operative conservative management. The decision of operative management should be taken on the basis of the hemodynamic status and not merely on the grade of the hepatic injury.

show abstract

“…Severe lung contusion often induces severe respiratory failure resulting from intra-lung bleeding [4]. Blush, which has been frequently reported in hepatic and splenic trauma, is defined as an image showing active extravasation of the intravenous contrast agent recognized on computed tomography (CT) [5][6][7]. Blush was reported to be observed in 6.6-17.1% of patients with severe hepatic and splenic trauma [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Blush, which has been frequently reported in hepatic and splenic trauma, is defined as an image showing active extravasation of the intravenous contrast agent recognized on computed tomography (CT) [5][6][7]. Blush was reported to be observed in 6.6-17.1% of patients with severe hepatic and splenic trauma [5][6][7][8][9][10]. Presence of blush in hepatic and splenic trauma indicates current progressive bleeding and implies the need for emergency hemostatic interventions such as transcatheter arterial embolization and abdominal surgery [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

“…Blush was reported to be observed in 6.6-17.1% of patients with severe hepatic and splenic trauma [5][6][7][8][9][10]. Presence of blush in hepatic and splenic trauma indicates current progressive bleeding and implies the need for emergency hemostatic interventions such as transcatheter arterial embolization and abdominal surgery [5][6][7][8][9][10]. Therefore, in some current management algorithms for hepatic and splenic trauma, blush has an important role in evaluating the necessity of emergency hemostatic interventions [5][6][7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Frequency and importance of blush in lung contusion in patients with blunt trauma: A retrospective observational study

Tominaga

Hayakawa

Yokobori

2021

Preprint

View full text Add to dashboard Cite

Background: The high mortality rate in patients with blunt chest trauma remains a problem. The assessment of blush in hepatic and splenic trauma is important because it indicates the need for emergency hemostatic intervention. However, the frequency and importance of blush in lung contusions are unknown. Therefore, this study aimed to evaluate the frequency of blush in the lung contusion and the relationship between blush and the clinical outcome of patients with blunt chest trauma.Methods: In this retrospective observational study, we enrolled patients with an injury severity score of 16 or higher and a chest abbreviated injury scale of 3 or higher who were admitted to the emergency department of Hokkaido University Hospital from January 1, 2003, to December 31, 2016. Blush was defined as an active extravasation image of an intravascular contrast agent recognized on contrast-enhanced computed tomography. Date of trauma severity, various treatments, and outcomes were recorded from the electrical medical records of the patients.Results: During the study period, 83 patients had severe lung contusions and 12 patients had blush. In-hospital mortality of patients with blush was significantly higher than that of patients without blush. Patients with blush required support through mechanical ventilation more frequently and for a longer duration than patients without blush.Conclusion: Our study revealed that blush in the lung contusions was not rare and was associated with a high risk of mortality in patients with severe blunt chest trauma. We should not hesitate to intervene if a blush of the lung contusion was detected in a patient with blunt chest trauma.

show abstract

Hepatic and splenic blush on computed tomography in children following blunt abdominal trauma

Abstract: Therapeutic study, level IV.

Cited by 31 publications

References 29 publications

Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma

Splenic injury severity, not admission hemodynamics, predicts need for surgery in pediatric blunt splenic trauma

Liver Injuries

Frequency and importance of blush in lung contusion in patients with blunt trauma: A retrospective observational study

Contact Info

Product

Resources

About