Multiple trauma including pelvic fracture with multiple arterial embolization: an autopsy case report

Thrombosis Journal
Takahito MiyakeShinji Ogura

Abstract

Pelvic fracture with high energy trauma has a high mortality rate, especially in men. In addition, severe multiple trauma, major hemorrhage, and administration of red blood cells predict mortality in elderly patients with pelvic fracture. We herein report a rare case in which multiple arterial embolization occurred after pelvic fracture. An 83-year-old male cyclist was transported to our hospital after being struck by a car. On arrival, he was diagnosed with multiple trauma, including rib fractures with hemothorax, lumbar fractures of the transverse process, and injuries in the right acetabulum, left adrenal gland, and liver. He underwent massive transfusion and transcatheter arterial embolization due to extravasation from the right superior gluteal artery and left adrenal gland. On the second day, owing to right lower leg ischemia, serum creatinine kinase and myoglobin levels were markedly elevated from the reference value; hence, a right above-knee amputation was performed 12 h after the accident. However, both protein levels remained high after amputation, resulting in acute renal injury, which was treated via hemodiafiltration on hospital day 3. In addition, sustained low efficiency hemodialysis and plasma exchange were per...Continue Reading

References

Jan 12, 2010·Thrombosis and Haemostasis·Joseph B Muhlestein
Jul 5, 2011·Critical Care Medicine·Daryl J KorUNKNOWN U.S. Critical Illness and Injury Trials Group: Lung Injury Prevention Study Investigators
Feb 23, 2012·Clinical Orthopaedics and Related Research·Joerg H HolsteinUNKNOWN Working Group Mortality in Pelvic Fracture Patients
Feb 7, 2016·BMC Pharmacology & Toxicology·Shmeylan A Al HarbiYaseen M Arabi
Nov 30, 2016·Critical Care Clinics·Mitchell J Cohen, S Ariane Christie
Dec 27, 2016·Journal of the American College of Surgeons·Jonathan P MeizosoKenneth G Proctor

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