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Related Experiment Videos

Hemorrhage and pelvic fractures.

A R Downs1, S Dhalla

  • 1Department of Surgery, Faculty of Medicine, University of Manitoba, Winnipeg.

Canadian Journal of Surgery. Journal Canadien De Chirurgie
|March 1, 1988
PubMed
Summary

Hemorrhage from pelvic fractures can be fatal. Management protocols for persistent bleeding, often from iliac or hypogastric artery injuries, involve angiography and embolization or surgical repair.

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Area of Science:

  • Trauma surgery
  • Vascular surgery
  • Emergency medicine

Background:

  • Hemorrhage is a primary cause of mortality in patients with pelvic fractures.
  • While bleeding is often self-limited in closed pelvic fractures, persistent hemorrhage poses a significant threat.
  • Identifying the source of intractable bleeding is crucial for effective patient management.

Purpose of the Study:

  • To outline a management protocol for patients experiencing persistent hemorrhage from pelvic fractures.
  • To differentiate between bleeding requiring surgical exploration versus endovascular intervention.
  • To improve outcomes for patients with severe pelvic fracture-related bleeding.

Main Methods:

  • Review of cases with persistent hemorrhage from pelvic fractures.
  • Diagnostic angiography to identify arterial injury.
  • Interventional radiology techniques such as embolization for arterial pseudoaneurysms or active extravasation.
  • Surgical exploration and repair for major iliac vessel disruption.

Main Results:

  • Persistent hemorrhage in pelvic fractures can stem from major iliac vessel injury or branches of the hypogastric artery.
  • Angiography is effective in identifying the bleeding source.
  • Embolization provides successful hemorrhage control for hypogastric artery branch disruptions.
  • Major iliac vessel injuries necessitate immediate surgical intervention.

Conclusions:

  • A structured management protocol can effectively guide treatment for hemorrhage in pelvic fractures.
  • Timely diagnosis and intervention, utilizing both endovascular and surgical techniques, are key to reducing mortality.
  • The proposed protocol aims to optimize the management of life-threatening hemorrhage associated with pelvic fractures.

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