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Semin Musculoskelet Radiol 2013; 17(04): 396-406
DOI: 10.1055/s-0033-1356469
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Diagnosis and Therapy of Acute Hemorrhage in Patients with Pelvic Fractures

Sebastian Kos
1   Klinik St. Anna, Institute of Radiology and Nuclear Medicine, Luzern, Switzerland
2   Department of Radiology, University of Basel, Basel, Switzerland
,
Andreas Gutzeit
1   Klinik St. Anna, Institute of Radiology and Nuclear Medicine, Luzern, Switzerland
3   Department of Radiology, Paracelsus Medical University Salzburg, Salzburg, Austria
,
Hanno Hoppe
4   Department of Radiology, Lindenhofspital Bern, Swiss Intervention Center for Microtherapy, Bern
5   Department of Radiology, University Hospital Bern, Freiburgstrasse, Bern, Switzerland
,
David M. Liu
6   Department of Radiology, Faculty of Medicine, University of British Columbia, Vancouver Canada
,
Augustinus L. Jacob
7   Klinik Hirslanden, Swiss Intervention Center of Microtherapy, Zürich, Switzerland
› Author Affiliations
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Publication History

Publication Date:
07 October 2013 (online)

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Abstract

Within the past 15 years, significant advances in the imaging of multiorgan and complex trauma primarily due to the improvement of cross-sectional imaging have resulted in the optimization of the expedient diagnosis and management of the polytrauma patient. At the forefront, multidetector computed tomography (MDCT) has become the cornerstone of modern emergency departments and trauma centers. In many institutions, MDCT is the de facto diagnostic tool upon trauma activation. In the setting of pelvic imaging, MDCT (with its high spatial resolution and sensitivity as well as short acquisition times) allows for rapid identification and assessment of pelvic hemorrhage leading to faster triage and definitive management. In trauma centers throughout the world, angiography and minimally invasive catheter-based embolization techniques performed by interventional radiologists have become the standard of care for patients with acute pelvic trauma and related multiorgan hemorrhage. In an interdisciplinary setting, embolization may be performed either alone or as an adjunct procedure with open or closed reduction and stabilization techniques. A team-based approach involving multiple disciplines (e.g., radiology, traumatology, orthopedic surgery, intensive care medicine) is crucial to monitor and treat the actively bleeding patient appropriately.

Keywords

bleeding - fracture - pelvic - embolization - intervention
 

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