Contained Hepatic Vascular Injuries Following Liver Trauma

Centre Hospitalier Universitaire de Nice318 enrolled

Overview

Background: For thirty years, a major shift in the management of liver trauma has been seen. Contained hepatic vascular injuries (CHVI), including pseudo aneurysms and arteriovenous fistula, are often feared due to their risk of secondary bleeding. Nonetheless, knowledge of CHVI is scarce and no guidelines on their management have been set. The investigators aimed to validate the risk factors of CHVI, identify associated morbidities, and establish a management protocol. Study Design: A retrospective study on 318 liver trauma from a level 1 trauma center over the last 15 years, comparing the presence or not of CHVI. Univarious and multivarious analyses were performed. A comparison of the management of CHVI was also performed.

Study Type

OBSERVATIONAL

Enrollment

318

Conditions

Hepatic Injury Liver Injury Pseudoaneurysm

Eligibility

Sex: ALLMin age: 15 Years

Medical Language ↔ Plain English

Inclusion Criteria: * presence of liver trauma * age above 15 years old * a full contrast abdominal CT Exclusion Criteria: none

Locations (1)

Outcomes

Primary Outcomes

Identification of a % of CHVI on the initial or the follow-up Chest-Thorax scans.

A junior and a senior radiologist reviewed all initial and follow-up CT scans, blinded from the diagnostic. Contained hepatic vascular injuries (CHVI) was defined as Hepatic Pseudoaneurysm (HPA) and/or arterio-venous fistula (AVF), under the American Association for Surgery of Trauma (AAST) organ injury scale (2018 revision) for liver trauma definition: a contained focal collection of vascular contrast which decreases in attenuation on delayed phase images on contrast-enhanced CT

Time frame: 6 months

Secondary Outcomes

Investigate the management of CHVI following liver trauma.

size in millimeters of pseudoaneurym conducting to angio-embolization

Time frame: 6 months