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Three-year-old traumatic liver injury patient treated successfully using transcatheter arterial embolization
Atsuyoshi Iida1, Tsuyoshi Ryuko2, Masaichi Kemmotsu2
1Critical Care Medical Center, Okayama Red Cross Hospital, Okayama, Japan.
Insights
Transcatheter arterial embolization (TAE) successfully treated liver injury in a 10 kg child, demonstrating its safety and efficacy in pediatric trauma. This minimally invasive approach offers a viable alternative for emergency hemostasis in young patients.
Area of Science:
- Pediatric Trauma Surgery
- Interventional Radiology
- Emergency Medicine
Background:
- Blunt abdominal trauma frequently causes liver injuries, particularly in children.
- Management strategies for pediatric blunt liver trauma have evolved significantly.
- Prompt diagnosis and intervention are crucial for favorable outcomes.
Observation:
- A 3-year-old girl weighing 10 kg sustained liver injury and intra-abdominal hemorrhage after being hit by a car.
- Computed tomography confirmed significant bleeding.
- Emergent transcatheter arterial embolization (TAE) was performed to control hemorrhage.
Findings:
- Transcatheter arterial embolization (TAE) achieved successful hemostasis without complications in this pediatric case.
- The patient experienced a good postoperative recovery and was discharged on day 9.
- This represents one of the youngest and lowest-weight successful emergency TAE cases for childhood liver injury.
Implications:
- Transcatheter arterial embolization (TAE) is a safe and effective option for emergency hemostasis in pediatric liver trauma, even in low-weight patients.
- Radiological interventions like TAE are vital adjuncts to the non-surgical management of childhood liver injuries.
- Emergency physicians should consider TAE as a critical tool in managing hemodynamically stable pediatric patients with liver trauma.
Introduction:
Liver injury is the most vulnerable to blunt abdominal trauma. Diagnostic evaluation and treatment of blunt liver trauma in children have changed essentially over the last decades.
Presentation Of Case:
A 3-year-old girl, weighing 10 kg was run over by a car and admitted to our hospital. Due to the liver injury and increased intra-abdominal hemorrhage confirmed by computed tomography, emergent transcatheter arterial embolization (TAE) was performed. Hemostasis was successfully obtained without complications. The patient had a good postoperative course and was discharged on the 9th day after admission.
Discussion:
To the best of our knowledge, this case is the youngest and lowest weight emergency TAE success cases of childhood liver injury. TAE is an alternative to laparotomy and a useful procedure to accomplish nonsurgical management in adult who are hemodynamically stable and have no other associated injury requiring laparotomy. On the other hand, TAE is considered to have some complications in child cases because of the small diameter of the artery and the tendency to spasm. Our case showed that TAE can be a safe option for emergency hemostasis in pediatric trauma cases weighing 10 kg.
Conclusion:
Emergency physicians must be aware that radiological intervention is an important adjunct to management of childhood liver injury.
