Blush at first sight significance of computed tomographic and angiographic discrepancy in patients with blunt abdominal trauma

Abdul Q. Alarhayem, John G Myers, Daniel L Dent, Daniel Lamus, Jorge E Lopera, Lillian Liao, Ramon Cestero, Ronald M Stewart, Brian J Eastridge

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background "Blush," defined as a focal area of contrast pooling within a hematoma, is frequently encountered in patients with severe blunt torso trauma. Contemporary clinical practice guidelines recommend the use of angiography with embolization in all hemodynamically stable patients with evidence of active extravasation. Patients presenting with blush visualized on computed tomography (CT), but not demonstrated on subsequent angiography, present a challenging clinical dilemma. The purpose of this study was to study the natural course of patients with this blush disparity between CT and angiography. Methods The study was conducted as a retrospective analysis of patients who underwent angiography after initial CT scans revealed blush after blunt abdominal trauma at a level I trauma center (January 2005 to December 2014). Results A total of 143 patients with blunt splenic injuries were found to have CT blush and underwent catheter angiography. Of the 143 patients with blush on CT, 24 (17%) showed no evidence of blush on angiography. Patients with CT-angiographic discrepancy were more than twice as likely to rebleed compared with those with angiographic evidence of blush (25% vs 10%, P

Original languageEnglish (US)
Pages (from-to)1104-1111
Number of pages8
JournalAmerican Journal of Surgery
Volume210
Issue number6
DOIs
StatePublished - Dec 1 2015

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Wounds and Injuries
Angiography
Tomography
Torso
Nonpenetrating Wounds
Trauma Centers
Practice Guidelines
Hematoma
Catheters

Keywords

  • Abdominal CT
  • Angiography
  • Embolization
  • Hemorrhage
  • Solid organ

ASJC Scopus subject areas

  • Surgery

Cite this

Alarhayem, A. Q., Myers, J. G., Dent, D. L., Lamus, D., Lopera, J. E., Liao, L., ... Eastridge, B. J. (2015). Blush at first sight significance of computed tomographic and angiographic discrepancy in patients with blunt abdominal trauma. American Journal of Surgery, 210(6), 1104-1111. https://doi.org/10.1016/j.amjsurg.2015.08.009

Blush at first sight significance of computed tomographic and angiographic discrepancy in patients with blunt abdominal trauma. / Alarhayem, Abdul Q.; Myers, John G; Dent, Daniel L; Lamus, Daniel; Lopera, Jorge E; Liao, Lillian; Cestero, Ramon; Stewart, Ronald M; Eastridge, Brian J.

In: American Journal of Surgery, Vol. 210, No. 6, 01.12.2015, p. 1104-1111.

Research output: Contribution to journalArticle

Alarhayem, Abdul Q. ; Myers, John G ; Dent, Daniel L ; Lamus, Daniel ; Lopera, Jorge E ; Liao, Lillian ; Cestero, Ramon ; Stewart, Ronald M ; Eastridge, Brian J. / Blush at first sight significance of computed tomographic and angiographic discrepancy in patients with blunt abdominal trauma. In: American Journal of Surgery. 2015 ; Vol. 210, No. 6. pp. 1104-1111.
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