[Management of severe pelvic fracture associated with injuries of viscera]
- PMID: 15842918
[Management of severe pelvic fracture associated with injuries of viscera]
Abstract
Objective: To probe the approach of emergency management for severe pelvic fracture associated with injuries of adjacent viscera and evaluate the therapeutic effect.
Methods: The data of 79 patients with severe pelvic fracture associated with injuries of adjacent viscera were retrospectively studied, and the study covered a period of 14 years.
Results: Ligation of internal iliac arteries was performed in 33 cases for ceasing massive bleeding due to pelvic fracture, and angioembolization in 8. Of 42 patients with cystic or/and urethral injury, 35 underwent cystostomy and delayed reconstruction, and 7 received a primary realignment. All of 17 patients with injury of retroperitoneal rectum underwent diverting colostomy of the proximal end of sigmoid with presacral drainage, but 4 received primary repair without colostomy. In 22 patients with intraperitoneal colorectal injury, 19 were managed with primary repair or anastomosis while 3 received a colostomy. The overall mortality rate was 9% (7/79); The main causes were hemorrhagic shock and associated injury. The complications included urethro-rectal fistula in 4, thrombosis of right common iliac artery in 1, acute respiratory distress syndrome (ARDS) following chest trauma in 1, and paraplegia in 1. Except the patient with paraplegia, all of them were cured.
Conclusions: Prompt diagnosis and proper treatment were the key of the success. Devascularization of internal iliac arteries with external fixation cage of pelvis, cystostomy and proximal sigmoidostomy were effective procedures frequently used in the emergency treatment of the severe pelvic fracture patients.
Similar articles
-
Management of severe pelvic fracture associated with injuries of adjacent viscera.Chin J Traumatol. 2005 Feb;8(1):13-6. Chin J Traumatol. 2005. PMID: 15676083
-
New therapeutic strategy of open pelvic fracture associated with rectal injury in 43 patients over 60 years of age.Hepatogastroenterology. 2002 Sep-Oct;49(47):1275-80. Hepatogastroenterology. 2002. PMID: 12239923
-
[Severe pelvic injuries: indications and techniques of skeletal fixation].Chir Ital. 1998;50(5-6):61-71. Chir Ital. 1998. PMID: 10392195 Italian.
-
[Perineal injuries in complicated pelvic trauma].Swiss Surg. 1996;(1):4-9. Swiss Surg. 1996. PMID: 8871256 Review. German.
-
Posttraumatic complete and partial loss of urethra with pelvic fracture in girls: an appraisal of management.J Urol. 2000 Jan;163(1):282-7. J Urol. 2000. PMID: 10604377 Review.
Cited by
-
Pelvic fracture urethral injury in males-mechanisms of injury, management options and outcomes.Transl Androl Urol. 2018 Mar;7(Suppl 1):S29-S62. doi: 10.21037/tau.2017.12.35. Transl Androl Urol. 2018. PMID: 29644168 Free PMC article. Review.
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Medical