Laparotomy and unstable pelvic fractures

Angioembolization and laparotomy for patients with concomitant pelvic arterial hemorrhage and blunt abdominal trauma

“…These also reflected that the treatment results were actually improved though the complication and mortality rates remained the same. The nontherapeutic laparotomy rate of patients with pelvic fracture has been reported to range from 29% to 72% [11,19]. In the current study, 21 (28%) laparotomies were classified as nontherapeutic; 16 (36%) of them were performed in the early 5-year period.…”

“…In the current study, 21 (28%) laparotomies were classified as nontherapeutic; 16 (36%) of them were performed in the early 5-year period. Nontherapeutic laparotomy was attributed to inadequate preoperative study [11,19]. A nontherapeutic laparotomy may adversely affect the prognosis of the patient [7,11].…”

“…However, to the best of our knowledge, only a few studies aimed at determining diagnosis and treatment strategies for patients with concomitant pelvic fracture and BAT [2,3,19,20]. No study has focused on patients with concomitant pelvic arterial hemorrhage and BAT requiring both angioembolization and laparotomy for the treatment.…”

Health-related quality of life and life satisfaction in patients following surgically treated pelvic ring fractures. A prospective observational study with two years follow-up

“…There is considerable morbidity not only due to the pelvic injury itself but also due to, for instance, associated vascular, neurological and urological injuries. 2,7,22 Common indications for surgery are instability and/or displacement, with the goal being restoration of stability within an anatomic or near anatomic position of the pelvic ring. There are numerous reports in the literature describing radiological and clinical results.…”

Angioembolization: Indications, Approach and Optimal Use

“…In another study, the rate of nontherapeutic laparotomies in patients with severe pelvic fractures was found to be 38 %. Two of these patients underwent laparotomy despite having a CT scan with no evidence of intraperitoneal hemorrhage, again, suggesting that, with proper workup, the rate of nontherapeutic laparotomy would be lower [48], and in a third study of patients with pelvic-fracture-related hemorrhage, FAST exam within 15 min of ED arrival had a 97 % positive predictive value for significant abdominal injury leading to therapeutic laparotomy [49]. In patients who have a CT scan, the size of hemoperitoneum, based on how many areas of the abdomen contain free fluid, can further discriminate the need for laparotomy [50••, 51].…”