Arteriography in the Management of Hemorrhage from Pelvic Fractures

Abstract

Localization of the source of massive hemorrhage from pelvic fractures is not often made clinically, and the results of expectant management or of hypogastric artery ligation are frequently unsatisfactory. Three patients with pelvic fractures and rapid blood loss were examined by transfemoral aortography. In all of them, bleeding originated from obturator artery branches In the vicinity of fractures involving the pubic rami. In two of these patients, hemorrhage was controlled by selective catheterization of the anterior division of the hypogastric artery, followed by injection of autologous clotted blood.