Sarah White, Presenter: Nothing to Disclose

Hani H. Abujudeh MD, Abstract Co-Author: Nothing to Disclose

Contrast enhanced CT (CECT) is an important tool in the management of pelvic arterial injuries. A blush on CECT is used often as a reason to perform pelvic angiography. However, the management of patients with a pelvic hematoma with no blush on CECT is still not clear. We aim to present our experience with this particular subset of patients.

We retrospectively reviewed the interventional radiology records from 2001-2003 for trauma patients who received pelvic angiography. We retrospectively reviewed the CECT scans performed on these patients prior to angiography.

A total of 57 patients had pelvic angiography. Embolization was performed in 51/57 patients. Active extravasations on angiography was seen in 31/51 patients. Other signs of vascular injury such as abrupt vascular cut-off, spasm, or dissection was seen in 20/51. Fifteen patients went to the OR prior to angiography and had no CECT. CECT was performed on 42/57 prior to angiography and in all 42 patients there was a pelvic hematoma. A blush was seen in 28/42 patients, and all 28 were embolized. In the remaining 24 patient with no blush on CECT, 11 were embolized, 5/11 due to active extravasation and 6/11 due to other signs of vascular injury. In the remaining 3/14 there was no evidence of vascular injury and no embolization was performed.

The presence of a vascular blush on CECT demands angiography and embolization. The absence of vascular blush on CECT in the presence of pelvic hematoma should not deter physicians from considering angiography and embolization

White, S, Abujudeh, H, Management of Pelvic Arterial Injuries in the Absence of Vascular Blush: What to Do?.  Radiological Society of North America 2004 Scientific Assembly and Annual Meeting, November 28 - December 3, 2004 ,Chicago IL. http://archive.rsna.org/2004/4416139.html