Twitter  Linkedin
 

Back to 2nd Annual Meeting Program


Pelvic Angiography for Trauma in Children: A Rare But Useful Adjunct
Brian Dalton, MD, Katherine W Gonzalez, Michael C Keirsey, Pablo Aguayo and David Juang, Children's Mercy Hospital, Kansas City MO

Abstract:
Introduction: Pelvic angiography with embolization for traumatic pelvic hemorrhage is a well described treatment in the adult population. There is a paucity of literature describing similar usage of pelvic angiography in the pediatric population. We describe our experience using angiography in children after traumatic pelvic fractures. Methods: A single center retrospective chart review at tertiary care pediatric center was performed from 2004 to 2014. All inpatients treated for a pelvic fracture were considered. Results: During the study period 216 patients were identified with pelvic fractures. Four patients (1.9%) required pelvic angiography. Three of these patients had active contrast extravasation at the time of angiography and underwent embolization with successful control of the hemorrhage. All patients requiring angiography showed computed tomography (CT) or clinical evidence of ongoing hemorrhage. Three of the four patients required blood transfusion in the trauma bay. Three also required blood transfusion after angiography. No surgical intervention was needed after angiography, and no complications of angiography were noted. Three patients found to have active extravasation on CT did not require angiography. In each case the etiology of extravasation (arterial or venous) was unclear. These 3 patients remained hemodynamically stable and required no intervention for bleeding. Overall mortality was 2.3% (5 of 216 patients). All deaths were secondary to concomitant traumatic brain injury. No mortality occurred in patients undergoing pelvic angiography, or those with pelvic contrast extravasation on CT. Conclusion: Pelvic angiography is a useful treatment option in pediatric patients with pelvic fractures and documented hemorrhage by CT or ongoing blood loss without other explanation.
Objective:
Discuss the role of pelvic angiography in pediatric trauma.
Objective Content: Pelvic angiography and emobolization of active hemorrhage has been used with success in adult patients. Limited data is available about pelvic angiography. We report a single institution experience pelvic angiography in pediatric patients after traumatic pelvic fractures.


Back to 2nd Annual Meeting Program