Preoperative interventional radiology in penetrating posterior abdominal trauma with bowel injury: A case report

Background

Penetrating posterior abdominal injuries pose a significant risk of retroperitoneal and intra-abdominal damage. Although interventional radiology (IR) is commonly used for hemorrhage control in trauma cases, the role of IR in penetrating bowel injuries is unclear because these injuries often require urgent surgical repair, limiting the use of IR as a primary intervention.

Case Presentation

A 76-year-old man sustained a penetrating posterior abdominal injury from a pruning shear, damaging the descending colon and lumbar arteries. Preoperative contrast-enhanced computed tomography (CT) revealed active extravasation into the colonic lumen and a retroperitoneal hematoma. A two-stage approach was implemented, starting with transcatheter arterial embolization of the lumbar artery, followed by surgical repair of the descending colon. Preoperative IR effectively controlled bleeding, enabling safe and efficient surgery.

Conclusion

Preoperative IR can help manage penetrating posterior abdominal injuries, including bowel damage, when active extravasation complicates surgery.