Abstract
Objective
Traumatic pseudoaneurysms are a serious complication following blunt and penetrating trauma, carrying a significant risk of morbidity and mortality if ruptured. However, there is a lack of specific guidelines for their detection and surveillance. This study aimed to evaluate the detection and management of posttraumatic solid organ pseudoaneurysms.
Materials and Methods
A prospectively maintained database was created at a Level 1 trauma center from January 2023 to June 2024. All patients aged 15 years and older who presented with a high-grade liver, kidney, or spleen injury were included in the study. Univariate data analyses was utilized with P < 0.05 considered statistically significant.
Results
Two hundred and five patients were included in the study. Pseudoaneurysms were identified in 10.7% of patients (n = 22/205). Gunshot wounds (n = 8/22, 36.4%) and motor vehicle collisions (n = 7/22, 31.8%) were the most common mechanisms of injury. Pseudoaneurysms were identified in the liver (n = 10/22, 45.5%), spleen (n = 9/22, 40.9%), and kidney (n = 3/22, 13.6%). 90.9% (n = 20/22) of pseudoaneurysms were identified within 5 days of initial injury. Seventeen (n = 17/22, 77.3%) patients underwent endovascular embolization for pseudoaneurysm repair with an 88.2% success rate. Five (n = 5/22, 22.7%) patients with pseudoaneurysms were managed by observation alone with no intervention. Overall, 48.3% (n = 99/205) of patients had a follow-up abdominal CTA prior to discharge.
Conclusion
Abdominal CTAs provide adequate surveillance for post-traumatic abdominal pseudoaneurysms, allowing for timely repair to decrease the risk of mortality from pseudoaneurysm rupture. Future prospective multi-center studies are needed to establish evidence-based guidelines for pseudoaneurysm detection and management.
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