title: Delayed presentation of hypovolemic shock after a simple pubic ramus fracture.
abstract: Although trauma-induced simple pubic ramus fracture is common in the emergency department (ED), it can result in life-threatening hemorrhagic shock. We describe a 58-year-old woman with closed minimally displaced simple pubic ramus fracture. Hemodynamic instability became apparent 2 hours later. She was successfully treated with transarterial embolization and discharged uneventfully 10 days later. Literature review showed involvement of the superior pubic ramus in all reported cases probably because of hemorrhage from “corona mortis” with delay in shock presentation mostly within 6 hours, suggesting at least an equivalent observation period for these patients, particularly those at high risk for hemorrhage.
authors.affiliation: Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
authors.forename: Wai-Ming
authors.initials: WM
authors.lastname: Kong
authors.forename: Cheuk-Kwan
authors.initials: CK
authors.lastname: Sun
authors.forename: I-Ting
authors.initials: IT
authors.lastname: Tsai
mesh_terms: D000792:Angiography; D004636:Emergency Service, Hospital; D005260:Female; D005596:Fractures, Closed / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D011630:Pubic Bone / Q000098:blood supply / Q000000981:diagnostic imaging / Q000293:injuries*; D012769:Shock / Q000209:etiology*; D013997:Time Factors; D014057:Tomography, X-Ray Computed