Control of massive retroperitoneal bleeding associated with pelvic fractures by angiographic embolization

Continuous retroperitoneal bleeding may be an immediate life-threatening complication of pelvic fractures. While surgical control of the bleeding vessels has been advocated in these cases, today angiographic embolization of the branches of the internal iliac arteries is proving to be the treatment of choice. This is a relatively simple, safe, prompt and effective method of controlling the hemorrhage. It avoids the disadvantages of surgery, general anesthesia, loss of the tamponade effect of the retroperitoneum when opened, and the not uncommon difficulty of identifying and ligating the bleeding vessels. Two cases in which massive retroperitoneal bleeding associated with pelvic fractures was controlled by angiographic embolization are described, illustrating the importance of early angiography.