The role of angiography in the management of haemorrhage from major fractures of the pelvis

The Journal of Bone and Joint Surgery. British Volume
R E CookI Gillespie

Abstract

In a series of 150 consecutive patients with unstable fractures of the pelvis, angiography was performed in 23 (15%) who had uncontrolled hypotension. There were three anteroposterior compression (APC), eight lateral compression (LC) and 12 vertical shear (VS) injuries. Arterial sources of haemorrhage were identified in 18 (78%) patients and embolisation was performed. Angiography was required in 28% of VS injuries. The morphology of the fracture was not a reliable guide to the associated vascular injury. Ten (43%) patients died, of whom six had had angiography as the first therapeutic intervention. Five of these had a fracture which was associated with an increase in pelvic volume (APC or VS) which could have been stabilised by an external fixator. Based on our findings we recommend skeletal stabilisation and, if indicated, laparotomy to deal with sources of intraperitoneal blood loss before pelvic angiography. Embolisation of pelvic arterial bleeding is a worthwhile procedure in patients with hypotension which is unresponsive to these interventions.

Citations

May 16, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Robert A JesingerRamit Lamba
Jul 19, 2005·Injury·Michael PerryMalcolm Cameron
Nov 19, 2010·Musculoskeletal Surgery·Michelangelo ScaglioneG Guido
Feb 20, 2013·European Journal of Trauma and Emergency Surgery : Official Publication of the European Trauma Society·J LindahlE Hirvensalo
Aug 10, 2006·Der Chirurg; Zeitschrift für alle Gebiete der operativen Medizen·M Galanski
May 18, 2011·International Orthopaedics·Efthimios J KaradimasPeter V Giannoudis
Feb 26, 2013·Journal of Vascular and Interventional Radiology : JVIR·Guy E JohnsonSiddharth A Padia
Mar 31, 2012·Current Problems in Diagnostic Radiology·Raffaella NiolaFranco Maglione
Sep 15, 2004·The Orthopedic Clinics of North America·David J Hak
Mar 12, 2010·European Journal of Radiology·S J Slater, D A Barron
Mar 13, 2009·Injury·Takashi SuzukiErnest E Moore
Dec 18, 2015·Der Unfallchirurg·E EsmerUNKNOWN das TraumaRegister DGU®
Oct 29, 2008·Journal of the American College of Surgeons·Ali SalimDemetrios Demetriades
Jun 19, 2004·Injury·P V Giannoudis, H C Pape
Jan 26, 2006·The Journal of Emergency Medicine·Jean Hammel, Eric Legome
Mar 15, 2015·Injury·S RuattiJ Tonetti
Mar 29, 2011·European Journal of Radiology·Costas PapakostidisPeter V Giannoudis
Dec 1, 2009·Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine·Igor JeroukhimovAriel Halevy
Apr 25, 2012·Medizinische Klinik, Intensivmedizin und Notfallmedizin·B HußmannS Lendemans
May 21, 2016·Orthopedics·Abdulrahman D AlgarniMamoun Kremli
Apr 17, 2014·Scandinavian Journal of Surgery : SJS : Official Organ for the Finnish Surgical Society and the Scandinavian Surgical Society·I Marzi, T Lustenberger
Jan 20, 2018·The Journal of the American Academy of Orthopaedic Surgeons·Rahul VaidyaKerellos Nasr
Oct 13, 2017·International Journal of Environmental Research and Public Health·Sheng-Der HsuDe-Chuan Chan
Nov 26, 2003·Current Opinion in Critical Care·Axel GänsslenHans-Christoph Pape
Sep 4, 2004·The Journal of Trauma·Steffen RuchholtzDieter Nast-Kolb
Oct 27, 2018·VASA. Zeitschrift für Gefässkrankheiten·Jos C van den Berg
Jun 12, 2008·The Journal of Trauma·John B KortbeekRobert Winter
Aug 13, 2008·The Journal of Trauma·Mark E ElzikLaurence E Dahners

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.

© 2022 Meta ULC. All rights reserved