Louis Delamare1, Laure Crognier1, Jean-Marie Conil2, Hervé Rousseau3, Bernard Georges2, Stéphanie Ruiz4. 1. Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France. 2. Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France. 3. Department of Radiology, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France. 4. Department of Anesthesiology and Intensive Care, Rangueil Hospital - University Hospital of Toulouse, 1, avenue du Professeur Jean-Poulhès TSA 50032, 31059 Toulouse cedex 9, France; EA 4564 - MATN - Laboratoire de Modélisation de l'Agression Tissulaire et de la Nociception, Institut Louis-Bugnard (IFR 150), Toulouse, France. Electronic address: ruiz.stephanie@chu-toulouse.fr.
Abstract
PURPOSE: Haemorrhagic shock is commonly encountered in the emergency room and is associated with high morbidity and mortality. For intra-thoracic and intra-abdominal bleeding, treatment usually requires either surgery or an interventional radiologic procedure. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has already been described for pelvic fractures and intra-abdominal haemorrhages. In this case report, we present the use of REBOA in a patient admitted for haemorrhagic shock due to a ruptured splenic artery aneurysm. CASE REPORT: We describe the case of a 35-year-old male with suspected massive pulmonary embolism. Prior to diagnostic confirmation by CT-scan, the patient suffered several cardiac arrests. CT-scan revealed a massive haemoperitoneum secondary to a ruptured aneurysm of the splenic artery. Because of refractory hypotension despite maximal conventional therapy, we used REBOA before patient transfer to the operating room for splenectomy. CONCLUSIONS: This case underlines the feasibility of REBOA and discusses its role in uncontrollable intra-abdominal haemorrhagic shock.
PURPOSE:Haemorrhagic shock is commonly encountered in the emergency room and is associated with high morbidity and mortality. For intra-thoracic and intra-abdominal bleeding, treatment usually requires either surgery or an interventional radiologic procedure. Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) has already been described for pelvic fractures and intra-abdominal haemorrhages. In this case report, we present the use of REBOA in a patient admitted for haemorrhagic shock due to a ruptured splenic artery aneurysm. CASE REPORT: We describe the case of a 35-year-old male with suspected massive pulmonary embolism. Prior to diagnostic confirmation by CT-scan, the patient suffered several cardiac arrests. CT-scan revealed a massive haemoperitoneum secondary to a ruptured aneurysm of the splenic artery. Because of refractory hypotension despite maximal conventional therapy, we used REBOA before patient transfer to the operating room for splenectomy. CONCLUSIONS: This case underlines the feasibility of REBOA and discusses its role in uncontrollable intra-abdominal haemorrhagic shock.
Authors: Jason N MacTaggart; William E Poulson; Maheen Akhter; Andreas Seas; Katherine Thorson; Nick Y Phillips; Anastasia S Desyatova; Alexey V Kamenskiy Journal: J Trauma Acute Care Surg Date: 2016-06 Impact factor: 3.313
Authors: Federico Coccolini; Philip F Stahel; Giulia Montori; Walter Biffl; Tal M Horer; Fausto Catena; Yoram Kluger; Ernest E Moore; Andrew B Peitzman; Rao Ivatury; Raul Coimbra; Gustavo Pereira Fraga; Bruno Pereira; Sandro Rizoli; Andrew Kirkpatrick; Ari Leppaniemi; Roberto Manfredi; Stefano Magnone; Osvaldo Chiara; Leonardo Solaini; Marco Ceresoli; Niccolò Allievi; Catherine Arvieux; George Velmahos; Zsolt Balogh; Noel Naidoo; Dieter Weber; Fikri Abu-Zidan; Massimo Sartelli; Luca Ansaloni Journal: World J Emerg Surg Date: 2017-01-18 Impact factor: 5.469