External Iliac Artery and Lumbosacral Plexus Injury Secondary to an Open Book Fracture of the Pelvis

Jd, Birchard; Dr, Pichora; Pm, Brown

doi:10.1097/00005373-199007000-00025

Cited by 11 publications

(4 citation statements)

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“…Most vascular injuries are venous, whereas arterial injuries involve the branches of the internal iliac artery or superior and inferior gluteal arteries [9], which are particularly vulnerable to trauma due to their relationship to the posterior pelvic bones that are disrupted by high-energy trauma. The superior and inferior gluteal arteries and terminal hypogastric branches are vulnerable to injury because of the close anatomic relationship between these arteries and bony structures.…”

Section: Discussionmentioning

confidence: 99%

External iliac artery injury with posterior pelvic ring injury in Korea: a report of two cases

Ahn

Kim

2023

J Trauma Inj

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Pelvic ring injuries associated with external iliac artery injuries are rare and may be life-threatening condition. The most important factors in the managements are the immediate bleeding control and restoration of distal blood flow. We report two cases of pelvic ring injuries with external artery injuries. One case was occlusion of external iliac artery with concomitant rupture of internal iliac artery. The other case was ruptured external iliac artery. Every surgeon must understand the possibility of hidden lesions-for example, arterial rupture and thrombus-and should consider the need for embolization or thrombectomy when treating this type of injury.

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Section: Discussionmentioning

confidence: 99%

External iliac artery injury with posterior pelvic ring injury in Korea: a report of two cases

Ahn

Kim

2023

J Trauma Inj

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“…The two branch ligaments around the spine of the inferior gluteal artery also have connections. Therefore, it is thought that the selective and non-selective embolization of the internal iliac artery serves as a reliable, safe and effective means of promoting hemostasis [ 16 , 17 ]. Some researchers have also proposed that embolization of the internal iliac artery might lead to the ischemic necrosis of the gluteal muscle [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Effects of internal iliac artery embolization on systemic inflammatory response syndrome in dogs with simulated-pelvic-fracture combined with massive bleeding

et al. 2016

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BackgroundPelvic fracture combined with massive bleeding (PFCMB) is a complex issue in clinical practice. Currently, the use of angiography and embolization for the treatment of PFCMB obtains good results. The aim of this study is to observe the effects of early internal iliac artery embolization on the SIRS in dogs with simulated-pelvic-fracture combined with massive bleeding.MethodsTwenty adult dogs were randomly divided into an embolization group (EG) and a control group (CG). For the two groups, heart rate, respiratory rate and body temperature and other physiological variables were measured, and IL-6, TNF-α and arterial blood gas levels were monitored. These variables were assayed every 30 min until death in the CG, while dogs in the EG underwent arterial angiography after 60 min of modeling. The internal iliac artery was embolized on the injured side.ResultsThe average time to SIRS in the CG was 3.56 h, occurring at a rate of 90 % (9/10) within 24 h, with a mortality rate of 50 % (5/10); the average time to SIRS for the EG was 5.33 h, occurring at a rate of 30 % (3/10) within 24 h, with a mortality rate of 10 % (1/10). When SIRS occurred in the EG, the mean plasma IL-6 level was 52.66 ± 7.38 pg/ml and the TNF-α level was 11.45 ± 2.72 ng/ml, showing a significant difference with those of the CG (P < 0.05). In the two groups, the respiratory rate and leukocyte levels were higher at each monitored time after modeling than those before modeling; the mean arterial pressure, levels of hemoglobin and oxygen partial pressure were significantly lower at each time point after modeling than those before modeling except for the mean arterial pressure at 0 h in EG; the platelet levels at 4 and 8 h were higher than those before modeling; and the differences were statistically significant (P < 0.05). In the EG, the mean arterial pressure, heart rate, respiratory rate and hemoglobin levels at 2 , 4 and 8 h were lower than those at 0 h; the levels of leukocytes, platelets and carbon dioxide partial pressure at 4 and 8 h after modeling were higher than those at 0 h, and the differences were statistically significant (P < 0.05, P < 0.01); in the CG after modeling, the mean arterial pressure, levels of hemoglobin and carbon dioxide partial pressure at 2, 4 and 8 h were lower than those at 0 h; the levels of heart rate and leukocytes were higher than those before modeling; the respiratory rate and platelet levels at 4 and 8 h were higher than those at 0 h; and the differences were statistically significant (P < 0.05). The levels of the mean arterial pressure and hemoglobin at 4 and 8 h and the pH values at 8 h after modeling in the EG were significantly higher than those in the CG, while the heart rate and respiratory rate at 4 and 8 h were significantly lower than those in the CG. The pH values at 8 h after modeling were significantly lower than those of the other monitored times in the CG (P < 0.05, P < 0.01). The two groups had elevated levels of alkaline phosphatase after injury induction.ConclusionThrough the use of an on-...

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“…The change in the pulse examination occurred two hours after the injury, which emphasize the need for serial vascular examinations. 15 Many reports of blunt aortoiliac arterial trauma suggest that acute limb-threatening ischemia is an unusual presenting sign, and most injuries are not recognised during acute phase of management. [16][17][18][19][20] A report from Tuech et al described nine patients with blunt iliac artery injury with median delay to operative repair of 15 days.…”

Section: Discussionmentioning

confidence: 99%

Iliac Arterial Injury Associated with Pelvic Fracture in Blunt Abdominal Trauma: A Case Report

Ip¹,

Kb²

2014

Hong Kong Journal of Emergency Medicine

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Exsanguination accounts for up to 65% mortality of traumatic patients with known pelvic fracture. Majority of the haemorrhage is caused by bleeding from venous plexuses and fractured cancellous bone. Arterial bleeding only accounts about 15% of the haemorrhage and primarily from branches of iliac arteries. Injury to iliac arteries with bleeding or thrombosis is uncommon and difficult to diagnose. It is a devastating condition associated with significant consequences including limb loss or even mortality without prompt diagnosis and management. The diagnosis can only be made with high index of suspicion and repeated careful examination. In this report, we describe the management of a case of pelvic fracture with multiple concomitant injures including common iliac artery occlusion that was successfully managed with a femorofemoral bypass. (Hong Kong j.emerg.med. 2014;21:329-333)

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External Iliac Artery and Lumbosacral Plexus Injury Secondary to an Open Book Fracture of the Pelvis

Cited by 11 publications

References 0 publications

External iliac artery injury with posterior pelvic ring injury in Korea: a report of two cases

External iliac artery injury with posterior pelvic ring injury in Korea: a report of two cases

Effects of internal iliac artery embolization on systemic inflammatory response syndrome in dogs with simulated-pelvic-fracture combined with massive bleeding

Iliac Arterial Injury Associated with Pelvic Fracture in Blunt Abdominal Trauma: A Case Report

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