Interventional radiology in pediatric blunt liver and spleen injuries: A multicenter retrospective observational study

作者：Naoya Miura, Asuka Tsuchiya, Morihiro Katsura, Naoki Sakoda, Seiji Morita, Yoshihide Nakagawa · 发表于：The Journal of Trauma: Injury, Infection, and Critical Care · 年份：2025 · DOI：10.1097/ta.0000000000004640 · 被引用次数：2 · 研究领域：Abdominal Trauma and Injuries、Trauma Management and Diagnosis、Trauma and Emergency Care Studies

BACKGROUND: Nonoperative management (NOM) is the standard of care for hemodynamically stable pediatric blunt liver and/or spleen injuries (BLSIs). The value of interventional radiology (IR) in NOM of pediatric BLSIs is not clearly established. This study aimed to describe the use and outcomes of IR in the management of pediatric BLSIs. METHODS: This post hoc analysis examined data from an 83-center retrospective study called the Splenic and Hepatic Injury in Pediatric Patients study in Japan. Participants included patients 16 years or younger who sustained BLSIs and received IR interventions between January 2008 and December 2019. The patients were categorized based on the indication for initial IR: acute hemorrhage, delayed hemorrhage/ruptured pseudoaneurysm, unruptured pseudoaneurysm, and others. The primary endpoint was IR failure, defined as requiring laparotomy after deciding for NOM with IR. Descriptive statistics were used to illustrate the baseline patient characteristics and IR treatment details. RESULTS: Among the 1,462 pediatric patients with BLSIs, 316 patients who underwent IR were evaluated. The median patient age was 11 years, and 68% were male. Organ injuries included 176, 118, and 20 splenic, liver, and simultaneous injuries, respectively. Contrast extravasation on pre-IR computed tomography imaging was found in 60.6% of the patients. The median time to IR from admission varied by indication, with the acute hemorrhage group treated in approximately 2 hours. T...