[Resuscitative endovascular balloon occlusion of the aorta (REBOA) in a multi-field center for a patient with severe combined abdominal trauma].

Abstract

Objective: To improve the treatment strategy in patients with severe combined abdominal trauma using minimally invasive technique (REBOA).

Material and methods: We present a patient with severe combined abdominal trauma (traffic accident) who underwent REBOA.

Results: The patient admitted to the intensive care unit in 65 min after traffic accident. Examination including eFAST and CT was performed within 25 min. The REBOA took 7 minutes. After that, the patient was transferred to the operating theatre under ongoing intensive therapy. The patient underwent emergency surgery: angiography, embolization of splenic arteries, fixation of anterior semicircle of the pelvis and right iliac wing with external fixation device, surgical treatment of wounds of the right shoulder and left forearm, open fractures of the patellae on both sides, plaster immobilization, external fixation of the right humerus and left forearm using the Ilizarov apparatus A prerequisite for successful treatment is «Damage-control» tactics (total surgery time was 102 min). After that, further treatment was continued in the intensive care unit. Intraoperative and early postoperative transfusion therapy was performed (packed red blood cells 1268 ml, fresh frozen plasma 1475 ml, platelets 420 ml). ICU-stay was 16 days, hospital-stay - 32 days.

Conclusion: Minimally invasive REBOA technology is important in the treatment of patients with severe combined abdominal trauma. Further accumulation of experience with subsequent analysis and evaluation of results is necessary.