CT evaluation of the pelvis after hemipelvectomy

From examination of 69 pelvic CT scans from 25 patients, the role of CT after hemipelvectomy is examined. A brief description of the various types of hemipelvectomy, including simple, extended, compound, and modified, is presented. The new variants of internal and modified internal hemipelvectomy are also included. The normal post-surgical changes in the musculoskeletal structures and pelvic viscera are described and illustrated. Postoperative abnormalities detected included hematoma, inflammatory changes, incisional hernia, ureteral obstruction, adenopathy, and local recurrence. An example of the usefulness of CT in CT-guided biopsy and CT-guided thermocouple placement is provided. CT of the pelvis is advocated as the method of choice to follow these patients, because of its ability to detect postoperative recurrence and complications.