Efficiency of embolization in traumatic and postoperative abdominopelvic bleeding

EFFICIENCY OF EMBOLIZATION IN TRAUMATIC AND POSTOPERATIVE ABDOMINOPELVIC BLEEDING Aim: The aim of this study is to evaluate the efficiency of embolization in traumatic and postoperative abdominopelvic hemorrhage. Material and Method: For this purpose, 31 patients admitted to Karadeniz Technical University Radiology department with posttraumatic and postoperative abdominopelvic hemorrhage between january 2006- september 2012 and treated with endovascular embolization are included in this study. In 16 patients those are hemodynamically stable, abdominal CT was performed to detect presence and/or localization of active hemorrhage. All patients (31 patients) underwent DSA and endovascular embolization. Results: Etiology of hemorrhage was surgical operation in 16 and trauma in 15 patients. Active hemorrhage was detected in all patients those evaluated with CT. 32 embolization procedures were done in 31 patients. According to localization and flow characteristics of hemorrhage NBCA-lipiodol, PVA particles, coils and autologous clot were the agents used in embolization. In all procedures embolization is successfully done (100% early technical success). No complications were observed during or after embolization. Because of recurrent hemorrhage one patient was treated with second embolization seance and one patient with surgery. One of the trauma patients death two days after the embolization because of concomitant multiorgan injury. Beyond these patients recurrent hemorrhage wasn't seen in other patients (93.3% late technical success). Conclusion: CT is a noninvasive, rapid method and has lower threshold for active hemorrhage rate, therefore may be used in detecting active hemorrhage instead of DSA. Endovascular embolization is an efficient and safe method in treatment of active hemorrhage. Beside stable patints, unstable patients may also be candidates for endovascular embolization in treatment of active hemorrhage in selected suitable conditions.