Contrast‐Enhanced Sonographically Guided Thermal Ablation for Treatment of Solid‐Organ Hemorrhage

The purpose of this series was to preliminarily evaluate the use of contrast‐enhanced sonographically guided percutaneous thermal ablation in the evaluation and treatment of solid‐organ bleeding by retrospectively analyzing 6 cases observed in clinical practice. Six patients who underwent contrast‐enhanced sonographically guided thermal ablation for treatment of solid‐organ bleeding (5 in liver and 1 in spleen) from December 2005 to August 2012 were included in this series. Clinical information, contrast‐enhanced sonograms before and after ablation, and the ablation method were retrospectively collected and analyzed. In 5 of the 6 patients, the location of the bleeding lesion was clearly seen. Hemostasis was successfully achieved in 4 of these 5 patients: 1 by radiofrequency ablation and 3 by microwave ablation. Ablation failed to achieve hemostasis in 1 patient who had postbiopsy splenic arterial bleeding because the bleeding vessel was a thick branch of the splenic artery. In the sixth remaining patient, who had bleeding after liver biopsy, hemostasis failed because contrast‐enhanced sonography did not precisely locate the bleeding lesion; hence, the ablation zone did not cover the whole lesion. Contrast‐enhanced sonographically guided ablation can be an alternative choice for treating solid‐organ bleeding because of its effectiveness and minimal invasiveness. However, it should be carefully investigated for those in whom the bleeding lesion cannot be located by contrast‐enhanced sonography and in those who have bleeding in a large vessel.