Abdominal Pseudoaneurysms in Patients With High-Grade Traumatic Injuries

Area of Science:

• Trauma Surgery
• Vascular Surgery
• Diagnostic Imaging

Background:

• Traumatic pseudoaneurysms (PSAs) are uncommon but life-threatening vascular injuries following trauma.
• CT scans are increasingly used in trauma evaluation, leading to more PSA diagnoses.
• Evidence supporting early PSA detection and optimal surveillance strategies is limited.

Purpose of the Study:

• To determine the incidence of solid organ PSAs in trauma patients.
• To identify common organ involvement and CT findings associated with PSAs.
• To evaluate current management and surveillance practices for traumatic PSAs.

Main Methods:

• Retrospective chart review of patients with American Association for the Surgery of Trauma (AAST) grade 3-5 solid organ injuries.
• Identification of patients diagnosed with PSAs.
• Analysis of CT findings, interventions (e.g., embolization), and patient outcomes.

Main Results:

• 47 patients with traumatic PSAs were identified, with the spleen being the most frequently affected organ.
• CT findings of contrast blush or extravasation were present in 33 patients.
• 36 patients underwent embolization; 3 required re-admission, and 1 experienced PSA rupture. Surveillance protocols varied significantly.

Conclusions:

• Solid organ PSAs are a notable complication in severe trauma, particularly splenic injuries.
• CT findings like contrast blush are key indicators for PSA.
• Standardized surveillance and evidence-based guidelines are crucial for managing traumatic PSAs.