The role of interventional radiology in emergency medicine

Trauma and infectious conditions often present as emergency situations requiring immediate intervention. Percutaneous drainage of pancreatic abscess significantly reduces morbidity and mortality and facilitates ultimate surgical debridement on an elective basis. Emergency percutaneous drainage of abdominal, pelvic, pararenal, perirenal, and intrarenal abscesses similarly reduces mortality, morbidity, and length of hospitalization. Identification of bacteria from the aspirate makes possible adjustment of antibiotic therapy. Decompression reduces the risk of septicemia, stabilizes the patient, and hastens defervescence. Definitive surgery can then be carried out at a reduced risk. Active bleeding sites can be diagnosed and often definitively handled by superselective embolization. Partial or complete dehiscence in the urinary tract and particularly the ureter or ureteropelvic junction can be definitively handled by percutaneously placed double 'J' stents. Such an intervention can be combined with vascular embolization of bleeding sites in the kidney.