둔상 후 복부 전산화단층촬영에서 조영제 유출로 동맥색전술을 시행받은 환자의 복강내와 후복막강/골반강내 출혈 비교

Comparison of Intraperitoneal and Retroperitoneal/Pelvic Contrast Extravasation: The Characteristics and Prognosis of the Each Patient Group with Arterial Embolization according to the Abdominal Computed Tomography Scanning after Blunt Trauma

  • 윤지영 (서울아산병원 응급의학과) ;
  • 김선휴 (울산대학교병원 응급의학과) ;
  • 안력 (울산대학교병원 응급의학과) ;
  • 황재철 (울산대학교병원 영상의학과) ;
  • 홍은석 (울산대학교병원 응급의학과)
  • Yoon, Ji Young (Department of Emergency Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sun Hyu (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Ahn, Ryeok (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hwang, Jae Cheol (Department of Radiology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Hong, Eun Seog (Department of Emergency Medicine, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 투고 : 2009.08.14
  • 심사 : 2009.11.13
  • 발행 : 2009.12.30

초록

Purpose: This study compared the characteristics of and the prognosis for intraperitoneal and retroperitoneal/pelvic contrast extravasation, which had been confirmed by enhanced abdominal CT scan, after blunt trauma in patients who had undergone angiographic embolization. Methods: From January 2001 to March 2009, data were retrospectively collected regarding patients who had undergone contrast extravasation (CE) on CT scanning and arterial embolization after blunt trauma. The study patient group was divided into the intraperitoneal and the retroperitoneal/pelvic groups according to the area of contrast extravasation. We reviewed the initial demographic data, the location of injury, the solid organ injury, the embolized vessel, and the clinical outcome. Results: The mean age of the study subjects was $40.2{\pm}2.6$ years old, and there were 24 male patients. The intraperitoneal group included 10 patients, and retroperitoneal/pelvic group was comprised of 17 patients. The amount of transfusion from presentation to intervention and during the first 24 hours was greater in the retroperitoneal/pelvic group than in the intraperitoneal group. The intraperitoneal group showed a higher frequency and severity of liver injury than the retroperitoneal/pelvic group. Angiography revealed that the hepatic artery (n=4) was the most frequently embolized vessel in the intraperitoneal group, while the internal iliac artery (n=6), followed by the renal artery (n=4), internal pudendal artery (n=3), and the gluteal artery (n=2), were the most frequently injured vessels in the retroperitoneal/pelvic group. Conclusion: In patients with intra-abdominal contrast extravasation found on CT scanning and arterial embolization after blunt trauma, the need for transfusion was less in the intra-abdominal group than in the retroperitoneal/pelvic group. Liver injury was also more frequent and severe in the intraperitoneal group than in the retroperitoneal/pelvic group.

키워드

참고문헌

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