Abstracts

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E1563. “IR We Going In?”: Non-Traumatic Interventional Radiology Emergencies for On-Call Radiology Residents
Authors
  1. Aakriti Mishra; University of New Mexico Hospital
  2. Daniel Harwood; University of New Mexico Hospital
  3. Darryl DeMaris; University of New Mexico Hospital
  4. William Schaeffer; University of New Mexico Hospital
  5. Paul Vantine; University of New Mexico Hospital
  6. Kevin Williams; University of New Mexico Hospital
  7. Ryan LeBaron; University of New Mexico Hospital
Background
Interventional radiology (IR) is a diverse medical specialty. The wide variety of both emergent and elective procedures requires a combination of astute diagnostic acumen and acute management skills. After-hours consults to the IR department are often based on a diagnostic radiology (DR) report. Diagnostic residents may be well versed in recognizing the “classic” IR emergencies such as traumatic hemorrhage. However, interventional radiologists are now responsible for an increasing number of patients with a variety of clinical presentations including both traumatic and non-traumatic etiology. Non-traumatic emergent cases requiring IR assistance will need to be recognized by the after-hours DR resident who must expedite patient care to improve outcomes.

Educational Goals / Teaching Points
This educational exhibit will improve resident education, decision-making, and overall comfort level when it comes to recognizing and escalating care for non-traumatic IR emergencies. We present several cases of emergent obstruction (urinary and biliary) as well as cases of non-traumatic, life-threatening hemorrhage, and findings portending hemorrhage. Further, factors that lead to successful intervention are reviewed. It is important for the DR resident to recognize not only imaging characteristics of IR emergencies, but also gather important information from the medical record. Recognition of both emergent radiologic findings and clinical status, to include recent procedures, are necessary to understand the finding and recommend prompt and appropriate IR consultation.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Specifically, we will discuss the imaging findings of and IR interventions for biliary obstruction, complicated pyelonephritis, non-traumatic visceral organ hemorrhage, visceral artery aneurysms, and postpartum uterine artery hemorrhage requiring emergent intervention.

Conclusion
Timely recognition and management of non-traumatic, life-threatening IR emergencies is crucial for improved patient care and outcomes. Therefore, it is advantageous to teach the diagnostic radiology residents about the various emergencies they may encounter while on call. Reviewing radiologic findings, clinical presentations, and patient management with DR residents can improve care and help DR residents feel adequately prepared for after-hours DR and IR on-call shifts.