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• Fourteen patients with posttraumatic pelvic hemorrhage underwent therapeutic transcatheter embolization of bleeding vessels. Six of them were victims of blunt trauma, six had penetrating trauma, and two had iatrogenic hemorrhage. Eleven patients had a celiotomy prior to angiographic embolization, and large retroperitoneal hematomas were evident in nine patients. Bleeding persisted postoperatively. It was initially controlled by embolization in all patients, but two rebled and were successfully reembolized. Two patients died because of traumatic injuries. There were no complications directly associated with the embolization procedures. Transcatheter embolization is a safe, effective method for controlling pelvic hemorrhage in patients with unstable or multiple pelvic fractures whose conditions fail to respond to more conventional forms of therapy.(Arch Surg 1983;118:1378-1383)

• Five patients with major symptomatic arteriovenous fistulas were treated between July 1976 and December 1977. In two patients the fistulas were due to trauma; in two others, malignant neoplasms; and in one patient, congenital angiodysplasia. The anatomic location or extent of each arteriovenous fistula would have made direct surgical access to the fistula sites difficult; therefore, it was elected to use arteriographic embolization techniques to attempt definitive obliteration of the fistulas. Wool-tufted wire coil emboli were used in three patients and gelatin sponge-autologous blood clot was used in two patients. These were precisely embolized to the fistula site by superselective catheterization of the feeding artery. Complete obliteration of the fistulas was achieved in each case with no morbidity. Follow-up clinical and arteriographic examination confirmed persistence of fistula closure.(Arch Surg 113:1153-1159, 1978)

Forty-eight patients with nephrotic syndrome were evaluated prospectively; the studies included inferior venacavagrams and ventilation perfusion lung scans. Eleven patients were found to have renal vein thrombosis (RVT). Eight of 21 patients with membranous glomerulonephritis (MGN) or membranoproliferative glomerulonephritis (MPGN) has RVT (38%). Clinical, laboratory, and pathological findings were not different among those patients with MGN and MPGN whether RVT was present or not. Patients with diabetic nephropathy or lupus nephritis did not have RVT. There was a high incidence of other thromboembolic phenomena as well as asymptomatic perfusion defects demonstrated by the lung scan, especially in patients with MGN or MPGN. These data suggest the disease process underlying the nephrotic syndrome may play a paramount role in the genesis of RVT or thromboembolic phenomena.(Arch Intern Med 137:333-336, 1977)

ALTHOUGH intralobar bronchopulmonary sequestration has been reported frequently in adults, few cases have been reported in the pediatric literature. This predominance of reports in adults is surprising because of the congenital nature of the malformation. The purpose of this article is to report a case of intralobar bronchopulmonary sequestration in a child. This diagnosis was suggested by a murmur heard over the left costovertebral angle in a 4 year 7-month-old child with a history of recurrent pneumonia, and a persistent mass noted in retrospect on a series of chest x-ray films. This is the second case report in which a murmur was heard over the back. REPORT OF A CASE The patient was born on Sept 2, 1960, in the University of California (Irvine) College of Medicine service at Los Angeles County General Hospital, Unit II. Pregnancy and delivery were uncomplicated. The birth weight was 3,289 gm (7 lb 4