Advertisement
Original communication| Volume 83, ISSUE 2, P133-137, February 1978

Selective arterial embolization for control of traumatic pelvic hemorrhage

      This paper is only available as a PDF. To read, Please Download here.

      Abstract

      Operative techniques for control of massive extraperitoneal bleeding after pelvic trauma have been disappointing. Extensive blood supply by ample collaterals alledgedly is responsible for the failure of proximal ligation of hypogastric arteries. Angiography has proved to be a valuable technique in the diagnosis and treatment of pelvic vascular injuries. Three patients are reported in which the diagnostic and therapeutic applications of angiography with subsequent embolization enabled the surgeon to avoid a difficult and possibly frustrating exploration. In addition, it provided an accurate indication for surgical intervention in one patient.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Binder S.S.
        • Mitchell G.A.
        The control of intractable pelvic hemorrhage by ligation of the hypogastric artery.
        South Med J. 1960; 53: 837
        • Byström J.
        • Dencker H.
        • Jäderling J.
        • et al.
        Ligation of the internal iliac artery to arrest massive haemorrhage following pelvic fracture.
        Acta Chir Scand. 1968; 134: 199
        • Engel G.C.
        • Singmaster L.
        Ligation of internal iliac arteries to facilitate abdominoperineal resection for malignancy of the rectum.
        Surgery. 1962; 52: 867
        • Ger R.
        • Condrea H.
        • Steichen F.M.
        Traumatic intrapelvic retroperitoneal hemorrhage.
        J Surg Res. 1969; 9: 31
        • Gerlock A.J.
        Hemorrhage following pelvic fracture controlled by embolization: Case report.
        J Trauma. 1975; 15: 740
        • Hauser C.W.
        • Perry J.F.
        Control of massive hemorrhage from pelvic fractures by hypogastric artery ligation.
        Surg Gynecol Obstet. 1965; 121: 313
        • Hawkins L.
        • Pomerantz M.
        • Eiseman B.
        Laparotomy at the time of pelvic fracture.
        J Trauma. 1970; 10: 619
        • Kelly H.
        Ligation of both internal iliac arteries for hemorrhage in hysterectomy for carcinoma uteri.
        Bull Johns Hopkins Hosp. 1894; 5: 53
        • Margolies M.N.
        • Ring E.J.
        • Waltman A.C.
        • et al.
        Arteriography in the management of hemorrhage from pelvic fractures.
        N Engl J Med. 1972; 287: 317
        • Miller W.E.
        Massive hemorrhage in fractures of the pelvis.
        South Med J. 1963; 56: 933
        • Motsay G.J.
        • Manlove C.
        • Perry J.F.
        Major venous injury with pelvic fracture.
        J Trauma. 1969; 9: 343
        • Peltier F.
        Complications associated with fractures of the pelvis.
        J Bone Joint Surg. 1965; 47-A: 1060
        • Quinby W.C.
        Fractures of the pelvis and associated injuries in children.
        J Pediatr Surg. 1966; 1: 353
        • Quinby W.C.
        Pelvic fractures with hemorrhage.
        N Engl J Med. 1971; 284: 668
        • Ravitch M.M.
        Hypogastric artery ligation in acute pelvic trauma.
        Surgery. 1964; 56: 601
        • Ring E.J.
        • Athanasoulis C.
        • Waltman A.C.
        • et al.
        Arteriographic management of hemorrhage following pelvic fracture.
        Diagn Radiol. 1973; 109: 65
        • Ring J.
        • Waltman A.C.
        • Athanasoulis C.
        • et al.
        Angiography in pelvic trauma.
        Surg Gynecol Obstet. 1974; 139: 375
        • Rösch J.
        • Dotter C.T.
        • Brown M.J.
        Selective Arterial Embolization.
        Diagn Radiol. 1972; 102: 303
        • Seavers R.
        • Lynch J.
        • Ballard R.
        • et al.
        Hypogastric artery ligation for uncontrollable hemorrhage in acute pelvic trauma.
        Surgery. 1963; 55: 516
        • Siegel P.
        • Mengert W.F.
        Internal iliac artery ligation in obstetrics and gynecology.
        JAMA. 1961; 178: 1059
        • Strandness D.E.
        Collateral circulation in clinical surgery.
        in: W. B. Saunders Co.,, Philadelphia1969: 461-472
        • Tadavarthy S.M.
        • Knight L.
        • Ovitt T.W.
        • et al.
        Therapeutic transcatheter arterial embolization.
        Diagn Radiol. 1974; 111: 13
        • Tajes R.V.
        Ligation of the hypogastric arteries and its complications in resection of cancer of the rectum.
        Am J Gastroenterol. 1965; 26: 612