Life-Threatening Bleeding from the Pubic Branch of the Inferior Epigastric Artery after Pubic Ramus Fracture

Abstract

Isolated pubic ramus fracture with concurrent life-threatening bleeding caused by injury to the inferior epigastric artery (IEA) or its branches has rarely been reported and can frequently be overlooked. This paper reports two cases of isolated pubic ramus fracture with concomitant injury to the pubic branch of the IEA, causing serious bleeding and hemodynamic instability. Pelvic angiography showed leakage of contrast from the pubic branch of the IEA. The complication in both cases was successfully treated with transcatheter arterial embolisation. (Hong Kong j.emerg.med. 2010;17:372-376)

Differentiating Between Obturator and Inferior Epigastric Arterial Injury in Traumatic Pelvic Hemorrhage: A Case Report

“…Once the injury is identified, it is important to differentiate between a hemorrhage originating from the pubic branch of OA and a hemorrhage originating from the pubic branch of the IEA. There are only a handful of cases that report internal hemorrhage as a result of injury to the pubic branches of the IEA [10][11][12][13][14][15], yet treatment with transarterial embolization remains the most effective solution in both scenarios. It is also possible that there is injury to both the pubic branches of the OA and the pubic branches of the IEA.…”

Inferior Epigastric Artery Injury Following Blunt Trauma Treated by Catheter Embolization

“…These injuries are rarely isolated, frequently co-existing with solid organ and bony injuries [9][10][11][12]. Low impact IEAI is extremely rare, but injury to the pubic branch of the inferior epigastric artery can be associated with isolated pubic ramus fractures, especially in patients receiving anticoagulation [13,14].…”