Pelvic fractures: diagnostic and therapeutic angiography

Pelvic ring disruption is part of a complex wounding pattern that challenges our ability to diagnose and manage hemorrhage. The conventional methods of diagnosis and control of abdominopelvic bleeding--peritoneal lavage and exploratory laparotomy--should be replaced by exploratory abdominopelvic angiography and transcatheter embolization. Angiography should be performed as soon as possible after the patient is admitted to the emergency room, and shock should not delay transfer of the patient to the angiography suite.