Traumatic mesenteric bleeding managed solely with transcatheter embolization.

Area of Science:

• Trauma Surgery
• Interventional Radiology
• Vascular Imaging

Background:

• Blunt abdominal trauma can cause mesenteric bleeding, a potentially life-threatening injury.
• Mesenteric hematomas with pseudoaneurysms require prompt management to prevent further hemorrhage.
• Surgical laparotomy has been the traditional treatment for significant mesenteric bleeding.

Observation:

• A 56-year-old female sustained blunt abdominal trauma resulting in mesenteric bleeding.
• Computed tomography revealed a large mesenteric hematoma, hemoperitoneum, and a pseudoaneurysm with extravasation.
• The bleeding originated from the right colic marginal artery.

Findings:

• Transcatheter arterial embolization (TAE) was performed to control the mesenteric bleeding.
• The right colic marginal artery pseudoaneurysm was successfully embolized using microcoils.
• Post-embolization, collateral circulation from the ileocolic artery maintained colon perfusion.
• The patient experienced no ischemic gastrointestinal complications and avoided surgery for 6 months.

Implications:

• TAE is a viable and effective alternative to emergency laparotomy for isolated mesenteric injuries.
• Minimally invasive embolization can successfully manage blunt traumatic mesenteric hemorrhage.
• Preservation of mesenteric blood flow via collateral circulation is crucial after embolization.