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Does Pelvic Hematoma on Admission Computed Tomography Predict Active Bleeding at Angiography for Pelvic Fracture?

Authors :
Carlos V.R. Brown
Alison Wilcox
Ali Salim
Demetrios Demetriades
Peter Rhee
George Kasotakis
Source :
The American Surgeon. 71:759-762
Publication Year :
2005
Publisher :
SAGE Publications, 2005.

Abstract

Pelvic angiography plays an increasing role in the management of pelvic fractures (PFs). Little has been written regarding the size of pelvic hematoma on admission computed tomography (CT) and how it relates to angiography results after PF. This is a retrospective review of trauma patients with PF who underwent an admission abdominal/pelvic CT scan and pelvic angiography from 2001 to 2003. CT pelvic hematoma was measured and classified as minimal or significant based on hematoma dimensions. Presence of a contrast blush on CT scan was also documented. Thirty-seven patients underwent an admission CT scan and went on to pelvic angiography. Of the 22 patients with significant pelvic hematoma, 73 per cent (n = 16) had bleeding at angiography. Fifteen patients had minimal pelvic hematoma, with 67 per cent (n = 10) showing active bleeding at angiography. In addition, five of six patients (83%) with no pelvic hematoma had active bleeding at angiography. Six patients had a blush on CT scan, with five of these (83%) having a positive angiogram. But, 22 of 31 (71%) patients with no blush on CT scan had bleeding at angiography. The absence of a pelvic hematoma or contrast blush should not alter indications for pelvic angiography, as they do not reliably exclude active pelvic bleeding.

Details

ISSN :
15559823 and 00031348
Volume :
71
Database :
OpenAIRE
Journal :
The American Surgeon
Accession number :
edsair.doi.dedup.....ab1b6ef3ef272f7cf78c180decb3a3d0
Full Text :
https://doi.org/10.1177/000313480507100913