Related Experiment Video
Updated: Oct 29, 2026
A New Hybrid Quantitative Evaluation Model for Axillary Junctional Hemorrhage in Swine
Published on: December 6, 2024
Localization of Non-Compressible Torso Hemorrhage with Contrast-Enhanced Ultrasound: A Swine Model
Yun Beom Lee1, Michael T Olson1, Micaela Cuneo1
1Department of Vascular Surgery, Brooke Army Medical Center, Fort Sam Houston, Texas.
Introduction:
Non-compressible torso hemorrhage (NCTH) remains a leading cause of preventable death in civilian and military trauma. In settings without cross-sectional imaging, the Focused Assessment with Sonography in Trauma (FAST) is used to detect hemoperitoneum but is limited in evaluating the retroperitoneum, is highly operator dependent, and cannot reliably localize bleeding. Contrast-enhanced ultrasound (CEUS) has demonstrated high sensitivity for solid organ pathology, but its role in detecting and localizing NCTH is not well defined.
Methods:
NCTH was induced in 18 swine (70-90 kg) via laparoscopic solid organ injury or endovascular injury to an aortic branch vessel. Standard FAST and CEUS were performed pre- and post-injury in a non-randomized, paired fashion. Outcomes included successful visualization of contrast extravasation with accurate localization of hemorrhage and time to hemorrhage detection.
Results:
Both CEUS and FAST detected hemoperitoneum in all cases. CEUS identified active contrast extravasation from solid organ and vascular injuries in 78% of cases and improved detection of low-volume hemoperitoneum. CEUS also detected hemorrhage in the retroperitoneum. Time to detection was similar between modalities.
Conclusion:
CEUS is a feasible adjunct to FAST for detecting and localizing NCTH. This swine model provides a reproducible platform for evaluating portable hemorrhage localization technologies in austere environments.
