BackTable / VI / Podcast / Episode #183

Solid Organ and Pelvic Trauma

with Dr. Chris Ingraham

Interventional Radiologist Dr. Chris Ingraham discusses his approach to treating solid organ and pelvic trauma, including embolization technique and IR's role in workflow efficiency for better trauma care.

Sponsored by:

Boston Scientific IOE
Solid Organ and Pelvic Trauma with Dr. Chris Ingraham on the BackTable VI Podcast)
Ep 183 Solid Organ and Pelvic Trauma with Dr. Chris Ingraham
00:00 / 01:04

BackTable, LLC (Producer). (2022, January 31). Ep. 183 – Solid Organ and Pelvic Trauma [Audio podcast]. Retrieved from https://www.backtable.com

BackTable CMEfy button

Stay Up To Date

Follow:

Subscribe:

Sign Up:

Podcast Contributors

Dr. Chris Ingraham discusses Solid Organ and Pelvic Trauma on the BackTable 183 Podcast

Dr. Chris Ingraham

Dr. Christopher Ingraham is a practicing interventional radiologist and associate professor at the University of Washington in Seattle.

Dr. Michael Barraza discusses Solid Organ and Pelvic Trauma on the BackTable 183 Podcast

Dr. Michael Barraza

Dr. Michael Barraza is a practicing interventional radiologist (and all around great guy) with Radiology Associates in Baton Rouge, LA.

Show Notes

In this episode, interventional radiologist Dr. Chris Ingraham and our host Dr. Michael Barraza discuss the role of IR in the trauma setting and approaches to embolization for trauma to the spleen, liver, kidneys, and pelvis.

Dr. Ingraham outlines Harborview Medical Center’s workup of trauma patients and describes the collaboration between the emergency, trauma surgery, and interventional radiology departments. Although CT provides more comprehensive imaging, Dr. Ingraham says that taking a patient directly to an angiogram could address the trauma quicker and prevent more complications. He also speaks about empiric embolization, noting that extravasation can be intermittent and not visible on imaging.

Overall, Dr. Ingraham recommends over-sizing coils, since patients are usually hypotensive and vasoconstrictive during active bleeding. Vessel diameter will eventually increase as patients are resuscitated.

When embolizing the spleen, Dr. Ingraham emphasizes that the goal is to prevent the need for splenectomy, especially in young patients, because of its role in immunologic responses. He advocates for proximal embolization in order to decrease the blood flow into the spleen and allow for splenic lacerations to clot and heal.

In liver embolization, Dr. Ingraham notes that there could be a laceration to the liver’s venous system, and embolization of the arterial system could reduce the dual blood supply of the liver. In these patients, there can be a higher risk of necrosis and biliary injury.

Finally, we discuss follow up care with pulse exams and monitoring of hemodynamic stability.

Resources

Balloons Up: Reduced Time to Angioembolization:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7903099/

SIR Trauma Guidelines, 2020:
https://www.jvir.org/article/S1051-0443(19)30952-2/fulltext

Disclaimer: The Materials available on BackTable.com are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

Earn CME When You Listen to BackTable CMEfy

Up Next

When that First Physician Job Isn't a Good Fit with Dr. Michael Barraza and Dr. Aaron Fritts on the BackTable VI Podcast)
New Tools to Treat Severe Distal Femoropopliteal Disease with Dr. John Rundback on the BackTable VI Podcast)

Articles

Topics

Get in touch!

We want to hear from you. Let us know if you’re interested in partnering with BackTable as a Podcast guest, a sponsor, or as a member of the BackTable Team.

Select which show(s) you would like to subscribe to:

Thanks! Message sent.