Intraabdominal Vascular Injuries in Blunt Trauma: Spectrum of Presentation, Severity and Management Options

Abstract

Purpose of Review Blunt abdominal vascular injury is rare, hard to diagnose and there is little consensus as to what constitutes best management. This review was undertaken to assess how blunt abdominal vascular trauma management has changed over last few years and what new therapies have been reported. Recent Findings Increasing diagnostic accuracy through the ubiquitous use of CT angiography has identified a greater range of injuries than clinicians were previously aware of. Most of these injuries can be managed non-interventionally but where intervention is required an increasing range of non-surgical options are available. Hemorrhage control with resuscitative balloon occlusion of the aorta has become popular and both covered and uncovered stents are available in situations where simple embolization is not feasible. Summary Patients with suspected blunt abdominal vascular injury need CT angiography to diagnose injuries and plan further management. Recently published literature suggests an increasing role of non-operative and endovascular treatment of these injuries. The role of open surgery is limited to a few situations and is more often a backup in the event of a failed endovascular intervention.