Pelvic Fracture Hemorrhage: Priorities in Management

B. Mark Evers, Henry M. Cryer, Frank B. Miller

Research output: Contribution to journalArticlepeer-review

146 Scopus citations

Abstract

Hemorrhage remains the leading cause of mortality in patients with severe pelvic fractures. To evaluate diagnostic and treatment priorities for this problem, we retrospectively reviewed 245 consecutive patients admitted to our institution with pelvic fractures. Supraumbilical diagnostic peritoneal lavage (DPL) was grossly positive in 27 patients, and eight (30%) of these had life-threatening intra-abdominal hemorrhage identified at laparotomy. No patient with a positive DPL by count alone had life-threatening intra-abdominal hemorrhage. Pelvic fracture stabilization with early external pelvic fixation was associated with less requirement for blood transfusion (10±1 U) than with the pneumatic antishock garment (17±3 U). Nine patients with pelvic arterial injuries underwent angiographic embolization, and eight patients died (89%). We conclude that pelvic angiography should be performed before laparotomy in hemodynamically unstable patients with pelvic fracture, unless the DPL is grossly positive.

Original languageEnglish
Pages (from-to)422-424
Number of pages3
JournalArchives of Surgery
Volume124
Issue number4
DOIs
StatePublished - Apr 1989

ASJC Scopus subject areas

  • Surgery

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