Does pelvic hematoma on admission computed tomography predict active bleeding at angiography for pelvic fracture?

Published

Journal Article

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.

Full Text

Duke Authors

Cited Authors

  • Brown, CVR; Kasotakis, G; Wilcox, A; Rhee, P; Salim, A; Demetriades, D

Published Date

  • September 2005

Published In

Volume / Issue

  • 71 / 9

Start / End Page

  • 759 - 762

PubMed ID

  • 16468513

Pubmed Central ID

  • 16468513

International Standard Serial Number (ISSN)

  • 0003-1348

Language

  • eng

Conference Location

  • United States