[Immediate vascular complications of severe pelvic fractures. Diagnosis and treatment]

Between 1975 and 1979 282 patients were treated for fractures of the pelvis at the Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland. Sixty-eight had severe fractures with two or more ruptures of the pelvis. Twelve of these patients also had vascular complications, viz. severe retroperitoneal hematoma, and rupture of the hypogastric artery or of the iliac vein. The histories, including the associated injuries, of these 68 patients were followed up from admission to hospital to discharge. The mortality was 11% for severe fractures of the pelvis and 33% in cases with vascular complications. The relative importance of diagnostic peritoneal lavage, angiography and surgery is stressed. Vascular embolization as an alternative treatment in the case of rupture of the hypogastric artery or branches is also discussed.