Hemorrhage associated with pelvic fractures: Causes, diagnosis, and emergent management

Y. Ben-Menachem, D. M. Coldwell, J. W.R. Young, A. R. Burgess

Research output: Contribution to journalReview articlepeer-review

Abstract

The high risk of exsanguinating hemorrhage in patients with pelvic ring disruption demands aggressive, yet balanced orthopedic and angiographic management as soon as patients are admitted to the emergency department. We present a perspective of our experience in two trauma centers and propose a logical approach to early prediction, diagnosis, and management of hemorrhage associated with pelvic fractures. Our method is based on knowledge of pelvic anatomy and an understanding of the mechanisms of injury and their wounding capacity, given that the mechanisms of injury determines the type of pelvic ring disruption and that the probability of arterial hemorrhage is - to a great extent - a function of the type of pelvic fracture. The risks of diagnostic peritoneal lavage and of excessive radiologic studies of noncritical injuries are emphasized. The principles guiding arterial embolization and the application of external fixators are discussed.

Original languageEnglish (US)
Pages (from-to)1005-1014
Number of pages10
JournalAmerican Journal of Roentgenology
Volume157
Issue number5
DOIs
StatePublished - 1991

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

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