Abdominal Pseudoaneurysms in Patients With High-Grade Traumatic Injuries

Utilization of CT scans in the work-up of trauma patients has led to increasing diagnosis of traumatic pseudoaneurysms (PSAs). While rare, PSAs have devastating consequences if ruptured. Evidence for the benefit of early detection of PSAs is lacking. The objective of this case series was to determine the incidence of solid organ PSAs after trauma. A retrospective chart review of patients with AAST grade 3-5 traumatic solid organ injuries was performed. 47 patients were identified with PSAs. PSAs were most common in the spleen. A CT finding of contrast blush or extravasation was found in 33 patients. 36 patients underwent embolization. 12 patients had an abdominal CTA prior to discharge. Re-admission was required for 3 patients. 1 patient presented with PSA rupture. During the study, there was no consistency in surveillance for PSAs. Future studies are needed to develop evidence-based practice guidelines for PSA surveillance in high risk populations.