Article Text


1603 Angiographic Embolization and Trauma: Successful Treatment in two Adolescents
  1. ML Conighi1,
  2. R Galeotti2,
  3. A Franchella1
  1. 1Pediatric Surgery
  2. 2Interventional Radiology, Universitary Hospital S. Anna, Ferrara, Italy


Background and Aims Since 1990s angiographic embolization is used in adult trauma for bleeding control and organ preservation. Experience in children is limited probably because of a higher success rate of non operative management for solid organ injuries (96–100%) and for technical limits due to smaller size of arteries. We present successful application of angiographic embolization in 2 adolescents.

Materials and Methods A 16 years old boy, involved in a scooter accident, presented with a pelvic trauma: extensive bones fractures associated with a large perineal wound extending to scrotum. At TC scan an arterial active bleeding was visible in pelvis. The second patient was a 17 years old polytraumatized boy, victim of a fall, who presented multiple blunt organ injuries (lungs, liver, spleen, left kidney) and bone fractures; at TC scan contrast extravasation was present in the lower pole of the spleen. Both patients were hemodynamically unstable.

Results First patient underwent, by a left femoral access, a selective angiography of hypogastric artery that permitted identification of the bleeding source: a scrotal branch of internal pudendal artery that undergoes embolization. In second patient angiography was conducted by a right femoral access: multiple pseudoaneurysms of the intraparenchymal splenic arteries had been identified and a superselective embolization was performed. Both patients reached hemodynamic stability after procedure. No complications occurred.

Conclusions Angiographic embolization can be a support to non operative management of trauma also in pediatric age to permit organ preservation and to avoid additional trauma of open surgery in critical patients.

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