Post-traumatic pelvic haemorrhage: What do I need to know?

In patients with blunt pelvic trauma, haemodynamic instability resulting from vascular lesions and active bleeding is the main cause of morbidity and mortality. In order to make treatment decisions, an accurate diagnosis of the origin and characteristics of the bleeding is required, whether from arteries, veins or bony surfaces. This article describes the anatomy of the pelvic vessels and the CT protocol for the diagnosis of vascular lesions. In addition, it presents a map of pelvic vascularisation that can help us quickly determine the artery most likely responsible for the bleeding in order to guide the interventional radiologist should embolisation be necessary. Early transarterial embolisation is the most effective intervention for managing arterial bleeding associated with pelvic fracture, and it has been proved useful in controlling bleeding and increasing survival.