Arteriography in the Management of Hemorrhage from Pelvic Fractures

Margolies, Michael N.; Ring, Ernest J.; Waltman, Arthur C.; Kerr, Walter S.; Baum, Stanley

doi:10.1056/nejm197208172870701

Cited by 238 publications

(63 citation statements)

References 15 publications

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“…As such, pelvic angiography, which was first reported by Margolies et al in 1972, has become the gold standard not only for the diagnosis, but also for the treatment, of pelvic arterial haemorrhage [22]. Patient deaths caused by the haemorrhage of a pelvic fracture frequently occur within the first 24 hours of injury.…”

Section: Discussionmentioning

confidence: 99%

“…Several investigators have attempted to define clinical or radiologic predictors for determining which patients with pelvic fractures are at high risk of arterial haemorrhage and thus might benefit from angiography and embolisation. As such, access to angiography varies among institutions [21][22][23]. There is a delicate balance between risking delayed intervention and performing many unnecessary angiographic procedures [24].…”

Section: Discussionmentioning

confidence: 99%

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The role of endovascular treatment of pelvic fracture bleeding in emergency settings

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

The role of endovascular treatment of pelvic fracture bleeding in emergency settings

et al. 2015

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“…The transcatheter arterial embolization of the internal iliac arteries was first described by Ring in 1972 and1973, respectively [12,13]. The indications of this treatment method have recently increased, and now it is commonly applied to the management of intractable hemorrhage due to traumatic, congenital, neoplastic and iatrogenic conditions [14][15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Transcatheter Embolization for the Treatment of Both Vaginal and Lower Intestinal Bleeding Due to Advanced Pelvic Malignancy

Karaman¹,

Ören²,

Andıç³

et al. 2010

EAJM

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We report a 31-year-old woman with end-stage cervical carcinoma who suff ers both lower intestinal and vaginal bleeding. A selective internal iliac arteriogram demonstrated pseudoaneurysm formation in the vaginal branch of the left internal iliac artery. There was also a fi stula between the pseudoaneurysm and the lower intestinal segments. Selective transcatheter coil embolization was performed, and the bleeding was treated successfully. We conclude that the internal iliac artery should be evaluated fi rst in patients with advanced pelvic malignancy when searching for the source of lower gastrointestinal (GI) bleeding. Additionally, transcatheter arterial embolization is a safe and eff ective treatment technique.Key Words: Angiography, Coil embolization, Hemorrhage, Lower gastrointestinal bleeding, Transcatheter ÖzetEş zamanlı vajinal ve alt intestinal kanamalı son dönem servikal kanseri bulunan 31 yaşındaki kadın hastanın transkateter koil embolizasyonunu sunuyoruz. Hastanın selektif iliak arteriogramında sol internal iliak arterinin vajinal dalında yalancı bir anevrizma formasyonu ve yalancı anevrizma ile alt intestinal segmentlerde fistül traktı gözlenmesi üzerine anjiografik girişim planlandı. Selektif koil embolizasyonu ile kanama başarılı olarak tedavi edildi.Olgudan çı-kardığımız sonuç ileri evre pelvik malignitesi olan hastalardaki alt intestinal kanamalarda öncelikle internal iliak arter çalışılmalıdır. Embolizasyon tedavileri de gelişen teknoloji ile birlikte oldukça başarılı hale gelmiştir.

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“…Patients are divided epidemiologically into two main groups: young people who had had highenergy trauma and elderly people who had sustained osteoporotic fractures after minor falls [4]. Cases associated with life-threatening arterial injury mostly relate to the high-energy group [4,[5][6][7][8]. Major pelvic hemorrhage in the low-energy group is uncommon and rare.…”

Section: Discussionmentioning

confidence: 99%

Arterial injury following a low energy pubic rami fracture

Sivan

Glyn-Jones

Hughes

et al. 2006

J Orthopaed Traumatol

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Patients with simple pubic rami fractures can be divided into two main groups: young people subject to high-energy trauma and elderly people who sustain osteoporotic fractures after minor falls. Cases associated with lifethreatening arterial injury mostly relate to the high-energy group. We report the case of a 70-year-old woman in whom a low-energy fall caused a stable pubic rami fracture injury associated with angiographyproven multiple hemorrhage from branches of both the internal and external iliac arteries which necessitated embolization of the bleeding vessels. As far as we are aware, angiography-proven bleeding from branches of the internal and external iliac arteries in a low-energy, stable pubic rami fracture has not been reported before. This case emphasizes the need for admission and careful hemodynamic monitoring in such cases.

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Arteriography in the Management of Hemorrhage from Pelvic Fractures

Cited by 238 publications

References 15 publications

The role of endovascular treatment of pelvic fracture bleeding in emergency settings

The role of endovascular treatment of pelvic fracture bleeding in emergency settings

Transcatheter Embolization for the Treatment of Both Vaginal and Lower Intestinal Bleeding Due to Advanced Pelvic Malignancy

Arterial injury following a low energy pubic rami fracture

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