The safety and efficacy of transarterial embolization for unstable-hemodynamics blunt abdominal trauma in the pediatric population.

PURPOSE: This work aimed to assess the safety and efficacy of transarterial embolization (TAE) for hemodynamically unstable blunt abdominal trauma in the pediatric population, and to explore optimal clinical treatment strategies for this population.

MATERIALS AND

METHODS

This retrospective study included 18 consecutive pediatric patients (median age: 5 years; interquartile range: 1.9-8 years; 8 females, 10 males) who underwent TAE for hemodynamically unstable blunt abdominal trauma in the emergency department of Children's Hospital between May 2016 and September 2024. Angiographic results were evaluated, and the embolic materials used, complications, and clinical outcomes were recorded.

RESULTS

Diagnostic angiography showed single-organ or single-site bleeding in 12 cases (66.7%) and two-site bleeding in six cases (33.3%). All bleeding sources were successfully embolized. Twelve patients (66.7%) were embolized with coil. After TAE, one case (5.6%) was combined with right thoracic closed drainage. Postoperative complications occurred in three (16.7%) children, including biliary fistula in two children and allantoic formation in one child. One child died of cerebral herniation and multiple-organ failure 10 days after embolization.

CONCLUSIONS

TAE demonstrates an acceptable mortality rate and low complication rate in the management of acute bleeding in hemodynamically unstable pediatric with blunt abdominal trauma. It is a viable therapeutic alternative for this patient population.