stumpfes Bauchtrauma

Computertomographie

einer traumatisch rupturierten Nierenzyste. Man erkennt teilweise noch die Zystenmembran der ursprünglich großen Zyste, aber auch reichlich Flüssigkeit drum herum.

Isoliert

intraparenchymatöse Leberruptur nach direkter, stumpfer Gewalteinwirkung. Rippenfraktur, aber kein Pneumothorax, fast keine freie Flüssigkeit.

Review of

proximal splenic artery embolization in blunt abdominal trauma. 65 year old female undergoing celiac angiogram for upper gastrointestinal bleed. Celiac DSA showing the dorsal pancreatic artery (thin arrows) arising directly from the celiac trunk (dotted black arrow), which occurs in ~ 15% of cases. The great pancreatic artery (curved black arrow) arises from the mid portion of the splenic artery. Ideal placement of coils/plugs in proximal splenic artery embolization is between these two vessels. Transverse pancreatic artery (thick black arrow)

Review of

proximal splenic artery embolization in blunt abdominal trauma. 32 year old male in a snowmobile verses truck accident. a Celiac DSA after proximal splenic artery embolization with an AMPLATZER™ Plug (black star). Note the dorsal pancreatic artery (thin straight black arrow) originates from the common hepatic artery, a variation that occurs in approximately 20% of cases. Blood from the dorsal pancreatic artery then travels left along the transverse pancreatic artery (thick black arrows). Blood then flows retrograde up the great pancreatic artery (curved black arrow) reconstituting the mid/distal splenic artery (thick white arrow). b Subsequent image shows reconstituted flow in the mid/distal splenic artery (thick white arrow) with opacification of splenic artery branches (thin white arrows)

Review of

proximal splenic artery embolization in blunt abdominal trauma. 52 yo male status post motor vehicle accident with grade 3 splenic injury. After coils were mistakenly placed distal to the origin of the great pancreatic artery (thin white arrow a, b), splenic artery DSA shows there is reconstitution of the distal splenic artery (thin black arrows b-d) via a great pancreatic artery to transverse pancreatic artery (thick white arrow b) to caudal pancreatic artery (curved white arrow b) pathway. The caudal pancreatic artery arises from the distal third of the splenic artery (70% of cases) or an inferior polar branch of the splenic artery (30% of cases)