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Imaging and Intervention in Post-traumatic Complications (Delayed Intervention)

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Emergency Radiology

2.2.9 Conclusion

As more patients with complex solid abdominal organ injuries are treated non-operatively and the criteria for NOM continue to expand, more patients will need some type of interventional procedure to treat complications that historically were managed by laparotomy

The application of the non-surgical approach and interventional radiology to manage delayed complications after abdominal trauma imposes prerequisite conditions: the clinician has to be aware of the natural history of abdominal trauma and the expected associated complications; an oriented clinical and radiological follow-up has to be performed; and the radiologist must have a training and skill in the different and complementary techniques required for the diagnosis and treatment of these complications. In addition, the approaches and treatment modalities may differ in adults compared with children. Some complications observed in children may resolve more frequently spontaneously (i.e. splenic pseudo-aneurysm), whereas treatment is indicated in adult (rupture and bleeding from the same aneurysm). The knowledge of this different natural history is mandatory in order to apply the most appropriate care to patients. Some post-traumatic lesions still require surgery (i.e. hollow viscus stenosis, diaphragmatic rupture, late-onset distal pancreatic duct stenosis). Finally, the optimal attitude is to combine the different complementary techniques in a multidisciplinary fashion. The shortcomings associated with NOM with or without embolisation, of solid abdominal organs injuries, are offset by the commonly used multidisciplinary approach in which interventional radiologists, gastroenterologists and urologists are teamed with trauma surgeon to resolve non-operatively most of the negative sequelae of these non-operative treatments

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Authors and Affiliations

  1. Department of Medical Imaging, Angiography and Interventional Radiology Unit, Saint-Luc University Hospital, Louvain Medical School, 10, avenue Hippocrate, 1200, Brussels, Belgium

    P. P. Goffette

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  1. P. P. Goffette
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  1. Institute of Diagnostic Radiology, University Hospital Zurich, Rämistrasse 100, 8091, Zurich, Switzerland

    Borut Marincek

  2. Department of Medical Imaging, University Hospital Sart Tilman, Domaine Universitaire du Sart Tilman B 35, 4000, Liège, Belgium

    Robert F. Dondelinger

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© 2007 Springer-Verlag Berlin Heidelberg

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Goffette, P.P. (2007). Imaging and Intervention in Post-traumatic Complications (Delayed Intervention). In: Marincek, B., Dondelinger, R.F. (eds) Emergency Radiology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-68908-9_4

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  • DOI: https://doi.org/10.1007/978-3-540-68908-9_4

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-26227-5

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