Interventional Radiology in the Management of Pelvic Fractures

ABSTRACT

Interventional radiology has a pivotal role in the evaluation and treatment of pelvic fractures. These devastating injuries are seen in every emergency room and should be treated by a multidisciplinary team. The radiographic evaluation should begin with the determination of which fracture pattern is present and then be correlated with the clinical condition of the patient. If a site of hemorrhage is present, the patient should then be investigated by interventional radiology, and the sites of bleeding embolized. The fracture patterns show distinctive predilection for injury to specific arteries. The care if the entire patient should be considered so that the interventions can have the greatest effect.

Trauma - pelvis - embolization

REFERENCES

• 1 Young J WR. Pelvic injuries.  Semin Musculoskelet Radiol . 1998;  2 83-104
• 2 Young J WR, Resnik C S. Fracture of the pelvis: current concepts of classification.  AJR Am J Roentgenol . 1990;  155 1169-1175
• 3 Ben-Menachem Y, Coldwell D M, Young J WR, Burgess A R. Hemorrhage associated with pelvic fractures: causes, diagnosis, and emergent management.  AJR Am J Roentgenol . 1991;  157 1005-1014
• 4 McIntyre R C, Bensard D D, Moore E E, Chambers J, Moore F A. Pelvic fracture geometry predicts risk of life-threatening hemorrhage in children.  J Trauma . 1993;  35 423-429
• 5 Takahira N, Shindo M, Tanaka K, Nishimaki H, Ohwada T, Itoman M. Gluteal muscle necrosis following transcatheter angiographic embolisation for retroperitoneal haemorrhage associated with pelvic fracture.  Injury . 2001;  32 27-32
• 6 Sieber P R. Bladder necrosis secondary to pelvic artery embolization: case report and literature review.  J Urol . 1994;  151 422
• 7 Haan J, Scott J, Boyd-Kranis R L, Ho S, Kramer M, Scalea T M. Admission angiography for blunt splenic injury: advantages and pitfalls.  J Trauma . 2001;  51 1161-1165
• 8 Coldwell D M, Novak Z, Ryu R K. et al . Treatment of posttraumatic internal carotid arterial pseudoaneurysms with endovascular stents.  J Trauma . 2000;  48 470-472