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Semin intervent Radiol 2021; 38(01): 131-138
DOI: 10.1055/s-0041-1726003
Review Article

Delayed and Chronic Sequelae of Trauma and the Role of the Interventional Radiologist

Robert Wolf
1   Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
2   Boston University School of Medicine, Boston, Massachusetts
,
Sara Smolinski-Zhao
1   Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts
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Abstract

In addition to acute injury requiring interventional radiologic treatments, patients with traumatic injuries can develop delayed or chronic complications. These injuries can involve nearly all solid organs in the abdomen. Coupled with significant improvements in visualizing these injuries with advanced imaging techniques such as minimally invasive procedures, nonoperative management of both acute traumatic injuries and their longer term sequelae has become the norm. This article reviews frequently seen complications of traumatic injury and their management by interventional radiologists.

Keywords

interventional radiology - trauma - complications - subacute injury - embolization - drainage


Publication History

Article published online:
15 April 2021

© 2021. Thieme. All rights reserved.

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  • References

  • 1 Goffette PP, Laterre P-F. Traumatic injuries: imaging and intervention in post-traumatic complications (delayed intervention). Eur Radiol 2002; 12 (05) 994-1021
    CrossrefPubMedGoogle Scholar
  • 2 Tisnado J, Ivatury RR. eds. Interventional Radiology in Trauma Management. Georg Thieme Verlag; 2016. :b-003-129394. DOI: 10.1055/b-003-129394
    Article in Thieme ConnectGoogle Scholar
  • 3 Brandt AH, Ewertsen C, Hansen KL. The impact of transient hepatic attenuation differences in the diagnosis of pseudoaneurysm and arteriovenous fistula on follow-up CT scans after blunt liver trauma. Diagnostics (Basel) 2014; 4 (03) 129-139
    CrossrefPubMedGoogle Scholar
  • 4 Piper GL, Peitzman AB. Current management of hepatic trauma. Surg Clin North Am 2010; 90 (04) 775-785
    CrossrefPubMedGoogle Scholar
  • 5 Zakaria HM, Oteem A, Gaballa NK. et al. Risk factors and management of different types of biliary injuries in blunt abdominal trauma: single-center retrospective cohort study. Ann Med Surg (Lond) 2020; 52: 36-43
    CrossrefPubMedGoogle Scholar
  • 6 Dabbs DN, Stein DM, Scalea TM. Major hepatic necrosis: a common complication after angioembolization for treatment of high-grade liver injuries. J Trauma 2009; 66 (03) 621-627 , discussion 627–629
    CrossrefPubMedGoogle Scholar
  • 7 Gilyard S, Shinn K, Nezami N. et al. Contemporary management of hepatic trauma: What IRs need to know. Semin Intervent Radiol 2020; 37 (01) 35-43
    Article in Thieme ConnectPubMedGoogle Scholar
  • 8 Bala M, Gazalla SA, Faroja M. et al. Complications of high grade liver injuries: management and outcome with focus on bile leaks. Scand J Trauma Resusc Emerg Med 2012; 20: 20
    CrossrefPubMedGoogle Scholar
  • 9 Kaufman SL, Kadir S, Mitchell SE. et al. Percutaneous transhepatic biliary drainage for bile leaks and fistulas. AJR Am J Roentgenol 1985; 144 (05) 1055-1058
    CrossrefPubMedGoogle Scholar
  • 10 Mohr AM, Lavery RF, Barone A. et al. Angiographic embolization for liver injuries: low mortality, high morbidity. J Trauma 2003; 55 (06) 1077-1081 , discussion 1081–1082
    CrossrefPubMedGoogle Scholar
  • 11 Saad WEA, Darcy MD. Percutaneous management of biliary leaks: biliary embosclerosis and ablation. Tech Vasc Interv Radiol 2008; 11 (02) 111-119
    CrossrefPubMedGoogle Scholar
  • 12 Perez-Johnston R, Deipolyi AR, Covey AM. Percutaneous biliary interventions. Gastroenterol Clin North Am 2018; 47 (03) 621-641
    CrossrefPubMedGoogle Scholar
  • 13 Nezami N, Jarmakani H, Arici M. et al. Selective trans-catheter coil embolization of cystic duct stump in post-cholecystectomy bile leak. Dig Dis Sci 2019; 64 (11) 3314-3320
    CrossrefPubMedGoogle Scholar
  • 14 Bouras A-F, Truant S, Pruvot F-R. Management of blunt hepatic trauma. J Visc Surg 2010; 147 (06) e351-e358
    CrossrefPubMedGoogle Scholar
  • 15 Green MHA, Duell RM, Johnson CD, Jamieson NV. Haemobilia. Br J Surg 2001; 88 (06) 773-786
    CrossrefPubMedGoogle Scholar
  • 16 Zhornitskiy A, Berry R, Han JY, Tabibian JH. Hemobilia: historical overview, clinical update, and current practices. Liver Int 2019; 39 (08) 1378-1388
    CrossrefPubMedGoogle Scholar
  • 17 Cathcart S, Birk JW, Tadros M, Schuster M. Hemobilia: an uncommon but notable cause of upper gastrointestinal bleeding. J Clin Gastroenterol 2017; 51 (09) 796-804
    CrossrefPubMedGoogle Scholar
  • 18 Le Roy B, Gelli M, Serji B, Memeo R, Vibert E. Portal biliopathy as a complication of extrahepatic portal hypertension: etiology, presentation and management. J Visc Surg 2015; 152 (03) 161-166
    CrossrefPubMedGoogle Scholar
  • 19 Maia MCA, Amaro AP, Oliveira EC. et al. Portal cholangiopathy: case report. Radiol Bras 2014; 47 (01) 51-53
    CrossrefPubMedGoogle Scholar
  • 20 Berry R, Han J, Girotra M, Tabibian JH. Hemobilia: perspective and role of the advanced endoscopist. Gastroenterol Res Pract 2018; 2018: 3670739
    CrossrefPubMedGoogle Scholar
  • 21 Schlansky B, Kaufman JA, Bakis G, Naugler WE. Portal biliopathy causing recurrent biliary obstruction and hemobilia. ACG Case Rep J 2013; 1 (01) 44-46
    CrossrefPubMedGoogle Scholar
  • 22 Lorenz JM, Funaki BS, Ray Jr CE. et al. ACR appropriateness criteria on percutaneous catheter drainage of infected fluid collections. J Am Coll Radiol 2009; 6 (12) 837-843
    CrossrefPubMedGoogle Scholar
  • 23 Heneghan HM, Healy NA, Martin ST. et al. Modern management of pyogenic hepatic abscess: a case series and review of the literature. BMC Res Notes 2011; 4 (01) 80
    CrossrefPubMedGoogle Scholar
  • 24 Haider SJ, Tarulli M, McNulty NJ, Hoffer EK. Liver abscesses: factors that influence outcome of percutaneous drainage. AJR Am J Roentgenol 2017; 209 (01) 205-213
    CrossrefPubMedGoogle Scholar
  • 25 Ahmed S, Chia CLK, Junnarkar SP, Woon W, Shelat VG. Percutaneous drainage for giant pyogenic liver abscess--is it safe and sufficient?. Am J Surg 2016; 211 (01) 95-101
    CrossrefPubMedGoogle Scholar
  • 26 Østerballe L, Helgstrand F, Axelsen T, Hillingsø J, Svendsen LB. Hepatic pseudoaneurysm after traumatic liver injury: Is CT follow-up warranted?. J Trauma Manag Outcomes 2014; 8: 18
    CrossrefPubMedGoogle Scholar
  • 27 Wagner ML, Streit S, Makley AT, Pritts TA, Goodman MD. Hepatic pseudoaneurysm incidence after liver trauma. J Surg Res 2020; 256: 623-628
    CrossrefPubMedGoogle Scholar
  • 28 Guzman EA, McCahill LE, Rogers FB. Arterioportal fistulas: introduction of a novel classification with therapeutic implications. J Gastrointest Surg 2006; 10 (04) 543-550
    CrossrefPubMedGoogle Scholar
  • 29 Kittaka H, Akimoto H, Tashiro K. A case report of spontaneous closure of a posttraumatic arterioportal fistula. Case Rep Emerg Med 2013; 2013: 623704
    PubMedGoogle Scholar
  • 30 Tanaka H, Iwai A, Sugimoto H, Yoshioka T, Sugimoto T. Intrahepatic arterioportal fistula after blunt hepatic trauma: case reports. J Trauma 1991; 31 (01) 143-146
    CrossrefPubMedGoogle Scholar
  • 31 Ibn Majdoub Hassani K, Mohsine R, Belkouchi A, Bensaid Y. Post-traumatic arteriovenous fistula of the hepatic pedicle. J Visc Surg 2010; 147 (05) e333-e336
    CrossrefPubMedGoogle Scholar
  • 32 Coelho DE, Ardengh JC, Carbalo MT, de Lima-Filho ÉR, Baron TH, Coelho JF. Clinicopathologic characteristics and endoscopic treatment of post-traumatic pancreatic pseudocysts. Pancreas 2011; 40 (03) 469-473
    CrossrefPubMedGoogle Scholar
  • 33 Debi U, Kaur R, Prasad KK, Sinha SK, Sinha A, Singh K. Pancreatic trauma: a concise review. World J Gastroenterol 2013; 19 (47) 9003-9011
    CrossrefPubMedGoogle Scholar
  • 34 Srikanth G, Sikora SS, Baijal SS. et al. Pancreatic abscess: 10 years experience. ANZ J Surg 2002; 72 (12) 881-886
    CrossrefPubMedGoogle Scholar
  • 35 Imanzadeh A, Kokabi N, Pourjabbar S. et al. Efficacy of percutaneous necrosectomy and debridement in patients with necrotizing pancreatitis. J Vasc Interv Radiol 2017; 28 (02) S56-S57
    CrossrefPubMedGoogle Scholar
  • 36 Ross A, Gluck M, Irani S. et al. Combined endoscopic and percutaneous drainage of organized pancreatic necrosis. Gastrointest Endosc 2010; 71 (01) 79-84
    CrossrefPubMedGoogle Scholar
  • 37 Lin B-C, Fang J-F, Wong Y-C, Liu N-J. Blunt pancreatic trauma and pseudocyst: management of major pancreatic duct injury. Injury 2007; 38 (05) 588-593
    CrossrefPubMedGoogle Scholar
  • 38 Funnell IC, Bornman PC, Krige JEJ, Beningfield SJ, Terblanche J. Endoscopic drainage of traumatic pancreatic pseudocyst. Br J Surg 1994; 81 (06) 879-881
    CrossrefPubMedGoogle Scholar
  • 39 Lee J, Darcy M. Renal cysts and urinomas. Semin Intervent Radiol 2011; 28 (04) 380-391
    Article in Thieme ConnectPubMedGoogle Scholar
  • 40 Titton RL, Gervais DA, Hahn PF, Harisinghani MG, Arellano RS, Mueller PR. Urine leaks and urinomas: diagnosis and imaging-guided intervention. Radiographics 2003; 23 (05) 1133-1147
    CrossrefPubMedGoogle Scholar
  • 41 Mani NBS, Kim L. The role of interventional radiology in urologic tract trauma. Semin Intervent Radiol 2011; 28 (04) 415-423
    Article in Thieme ConnectPubMedGoogle Scholar
  • 42 Anderson H, Alyas F, Edwin PJ. Intra-urinoma rendezvous using a transconduit approach to re-establish ureteric integrity. Cardiovasc Intervent Radiol 2005; 28 (01) 95-97
    CrossrefPubMedGoogle Scholar
  • 43 Nouri YM, Chu HH, Shin JH. et al. Percutaneous obliteration of urinary leakage after partial nephrectomy using N-butyl-cyanoacrylate obliteration of the urinoma with or without coil embolization of the fistula tract. J Vasc Interv Radiol 2019; 30 (12) 2002-2008
    CrossrefPubMedGoogle Scholar
  • 44 Johnsen NV, Vanni AJ, Voelzke BB. Risk of infectious complications in pelvic fracture urethral injury patients managed with internal fixation and suprapubic catheter placement. J Trauma Acute Care Surg 2018; 85 (03) 536-540
    CrossrefPubMedGoogle Scholar
  • 45 Moses RA, Selph JP, Voelzke BB. et al; From the Trauma and Urologic Reconstruction Network of Surgeons (TURNS). An American Association for the Surgery of Trauma (AAST) prospective multi-center research protocol: outcomes of urethral realignment versus suprapubic cystostomy after pelvic fracture urethral injury. Transl Androl Urol 2018; 7 (04) 512-520
    CrossrefPubMedGoogle Scholar
  • 46 Zaid UB, Bayne DB, Harris CR, Alwaal A, McAninch JW, Breyer BN. Penetrating trauma to the ureter, bladder, and urethra. Curr Trauma Rep 2015; 1 (02) 119-124
    CrossrefPubMedGoogle Scholar
  • 47 Hunter KF, Bharmal A, Moore KN. Long-term bladder drainage: suprapubic catheter versus other methods: a scoping review. Neurourol Urodyn 2013; 32 (07) 944-951
    CrossrefPubMedGoogle Scholar
  • 48 El Masri y WS, Patil S, Prasanna KV, Chowdhury JR. To cystoscope or not to cystoscope patients with traumatic spinal cord injuries managed with indwelling urethral or suprapubic catheters? That is the question!. Spinal Cord 2014; 52 (01) 49-53
    CrossrefPubMedGoogle Scholar
  • 49 Jane Hall S, Harrison S, Harding C, Reid S, Parkinson R. British Association of Urological Surgeons suprapubic catheter practice guidelines - revised. BJU Int 2020; 126 (04) 416-422
    CrossrefPubMedGoogle Scholar
  • 50 Jacob P, Rai BP, Todd AW. Suprapubic catheter insertion using an ultrasound-guided technique and literature review. BJU Int 2012; 110 (06) 779-784
    CrossrefPubMedGoogle Scholar
  • 51 van Den Hauwe L, Sundgren PC, Flanders AE. Spinal trauma and spinal cord injury (SCI). In: Hodler J, Kubik-Huch RA, von Schulthess GK. eds. Diseases of the Brain, Head and Neck, Spine 2020–2023: Diagnostic Imaging. IDKD Springer Series. Springer International Publishing; 2020: 231-240
    CrossrefGoogle Scholar
  • 52 Grant Jr RP, Gifford Jr RW, Pudvan WR, Meaney TF, Straffon RA, McCormack LJ. Renal trauma and hypertension. Am J Cardiol 1971; 27 (02) 173-176
    CrossrefPubMedGoogle Scholar
  • 53 Monstrey SJ, Beerthuizen GI, vander Werken C, Debruyne FM, Goris RJ. Renal trauma and hypertension. J Trauma 1989; 29 (01) 65-70
    CrossrefPubMedGoogle Scholar
  • 54 Judd E, Lockhart ME, Rizk DV. Renovascular hypertension associated with pseudoaneurysm following blunt trauma. Am J Kidney Dis 2013; 62 (04) 839-843
    CrossrefPubMedGoogle Scholar
  • 55 Aldiwani M, Georgiades F, Omar I. et al. Traumatic renal injury in a UK major trauma centre - current management strategies and the role of early re-imaging. BJU Int 2019; ; (epub ahead of print) DOI: 10.1111/bju.14752.
    CrossrefPubMedGoogle Scholar
  • 56 Aulakh TS, Hayne D, Hinwood D. Delayed presentation of arteriovenous fistula 20 years after blunt renal trauma. Int Urol Nephrol 2007; 39 (03) 713-715
    CrossrefPubMedGoogle Scholar
  • 57 Tallón-Aguilar L, López-Ruiz JA, Domínguez-Sánchez C, Pareja-Ciuró F, Padillo-Ruiz J. Laparoscopic approach in post-traumatic chylous ascites. Ann R Coll Surg Engl 2018; 100 (03) e57-e58
    CrossrefPubMedGoogle Scholar
  • 58 Lee J, Cho JS, Hoseok I, Kim YD. Delayed right chylothorax after left blunt chest trauma: a case report. J Med Case Reports 2017; 11 (01) 98
    CrossrefPubMedGoogle Scholar
  • 59 McGrath EE, Blades Z, Anderson PB. Chylothorax: aetiology, diagnosis and therapeutic options. Respir Med 2010; 104 (01) 1-8
    CrossrefPubMedGoogle Scholar
  • 60 Silen ML, Weber TR. Management of thoracic duct injury associated with fracture-dislocation of the spine following blunt trauma. J Trauma 1995; 39 (06) 1185-1187
    CrossrefPubMedGoogle Scholar
  • 61 Seitelman E, Arellano JJ, Takabe K, Barrett L, Faust G, Angus LDG. Chylothorax after blunt trauma. J Thorac Dis 2012; 4 (03) 327-330
    PubMedGoogle Scholar
  • 62 Litherland B, Given M, Lyon S. Percutaneous radiological management of high-output chylothorax with CT-guided needle disruption. J Med Imaging Radiat Oncol 2008; 52 (02) 164-167
    CrossrefPubMedGoogle Scholar
  • 63 Lyon S, Mott N, Koukounaras J, Shoobridge J, Hudson PV. Role of interventional radiology in the management of chylothorax: a review of the current management of high output chylothorax. Cardiovasc Intervent Radiol 2013; 36 (03) 599-607
    CrossrefPubMedGoogle Scholar
  • 64 Stecker MS, Pamarthi V, Steigner ML, Fan C-M. Utility of planning MRI in percutaneous thoracic duct embolization for chylothorax. Clin Imaging 2020; 64: 43-49
    CrossrefPubMedGoogle Scholar
  • 65 Schwartz FR, James O, Kuo PH, Witte MH, Koweek LM, Pabon-Ramos WM. Lymphatic imaging: current noninvasive and invasive techniques. Semin Intervent Radiol 2020; 37 (03) 237-249
    Article in Thieme ConnectPubMedGoogle Scholar
  • 66 Matsumoto T, Yamagami T, Kato T. et al. The effectiveness of lymphangiography as a treatment method for various chyle leakages. Br J Radiol 2009; 82 (976) 286-290
    CrossrefPubMedGoogle Scholar
  • 67 Yannes M, Shin D, McCluskey K, Varma R, Santos E. Comparative analysis of intranodal lymphangiography with percutaneous intervention for postsurgical chylous effusions. J Vasc Interv Radiol 2017; 28 (05) 704-711
    CrossrefPubMedGoogle Scholar