Hiroshi Kondo MD, Presenter: Nothing to Disclose

Satoshi Goshima MD, PhD, Abstract Co-Author: Nothing to Disclose

Haruo Watanabe MD, Abstract Co-Author: Nothing to Disclose

Hiroshi Kawada MD, Abstract Co-Author: Nothing to Disclose

Masayuki Kanematsu MD, Abstract Co-Author: Nothing to Disclose

Our institutional review board approved this retrospective study. We retrospectively searched our patient records. A total of 225 patients with abdominopelvic injuries were admitted to our hospital between January 2006 and September 2009. Of them, 28 did not respond to the initial fluid resuscitation, and 63 with extravasation or gastrointestinal perforation on initial contrast-enhanced CT underwent an immediate surgery or transcatheter arterial embolization. The remaining 134 (97 men and 37 women; 6-97 yrs, mean 44.6 yrs) patients constituted the study cohort. They underwent follow-up contrast-enhanced CTs on the 2nd and 8-11th hospital days. Based on the follow-up CT findings, patients were assigned in two groups: delayed TPA group (n = 15) and non-TPA group (n = 119). We assessed the frequencies, intervals until the development of TPA, and relations with injury severity score (ISS) and shock index.

Delayed TPA developed in 15 patients (11%; size range 5-30 mm; mean, 9.4 mm). The interval until detection of TPA was 7.6 ± 5.9 days. No significant difference in ISS was found between the delayed TPA (28.3 ± 11.2) and non-TPA (19.0 ± 11.5) groups. Shock index was significantly higher in delayed TPA (0.89 ± 0.39) than in non-TPA (0.73 ± 0.26) group (P < 0.05). The TPAs were asymptomatic in 14 patients and ruptured in 7 days in one. Delayed TPAs in twelve patients were successfully treated with transcatheter arterial embolization, and TPAs conservatively managed in the remaining three patients (tiny TPA in two, treatment failure in one) disappeared during follow-up.

Delayed TPA occasionally developed asymptomatically in patients post abdominopelvic blunt trauma. Most of them were small and were successfully treated by transcatheter arterial embolization and some disappeared without treatment.

Delayed TPA occasionally developed asymptomatically in patients post abdominopelvic blunt trauma. Most of them were small and were successfully treated by transcatheter arterial embolization and some disappeared without treatment.

Understanding and recognizing frequency, clinical manifestation, and imaging features of delayed TPAs.

Kondo, H, Goshima, S, Watanabe, H, Kawada, H, Kanematsu, M, To Assess the Frequency, Clinical Manifestation, and Imaging Features of Delayed Posttraumatic Abdominopelvic Pseudoaneurysms (TPAs).  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11003304.html