title: Hemorrhage after low-energy pelvic trauma.
abstract: BACKGROUND
  Severe pelvic hemorrhage after low-energy trauma has been described in some reports of single cases only. However, it might not be as rare and unique as generally expected. The aim of this study was therefore to present a case series of 11 patients with severe pelvic hemorrhage after sustaining low-energy trauma and to discuss relevant considerations for the management of these patients.
  
  
  METHODS
  A consecutive series of eleven patients with pelvic hemorrhage and the need for arterial embolization after sustaining low-energy pelvic trauma was identified. A contrast-enhanced computed tomography (CT) scan was performed in all patients, if pelvic hemorrhage was suspected due to a relevant hemoglobin (Hb) drop. After the CT scans showed active arterial bleeding, arterial embolization was immediately performed.
  
  
  RESULTS
  All patients sustained low-energy pelvic injuries after simple falls from standing height. The mean initial Hb level was 13.0 g/dL.Contrast-enhanced CT scans were performed after a mean of 14.3 hours after trauma and showed contrast medium extravasations in all patients. The mean Hb level at the time of CT scan was 9.0 g/dL. Embolization was successfully performed in all patients within a mean of 4.5 hours.
  
  
  CONCLUSIONS
  Geriatric patients are prone to arterial hemorrhage after low-energy pelvic trauma. They should be admitted as an inpatient for observation with repeated control of the Hb level to diagnose hemorrhage at an early stage. Contrast-enhanced CT scans is the preferred imaging method for the assessment of pelvic hemorrhage, whereas arterial embolization is highly successful in terms of hemostasis.
authors.affiliation: Department of TraumaSurgery and Sports Medicine, Medical University Innsbruck, Anichstraße 35, Innsbruck, Austria. dietmar@krappinger.eu
authors.forename: Dietmar
authors.initials: D
authors.lastname: Krappinger
authors.forename: Michael
authors.initials: M
authors.lastname: Zegg
authors.forename: Christian
authors.initials: C
authors.lastname: Jeske
authors.forename: Rene
authors.initials: R
authors.lastname: El Attal
authors.forename: Michael
authors.initials: M
authors.lastname: Blauth
authors.forename: Michael
authors.initials: M
authors.lastname: Rieger
mesh_terms: D000058:Accidental Falls; D000368:Aged; D003287:Contrast Media; D004621:Embolization, Therapeutic; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging; D005260:Female; D006470:Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy*; D006801:Humans; D008297:Male; D010388:Pelvis / Q000000981:diagnostic imaging / Q000293:injuries*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014949:Wounds, Nonpenetrating / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy*
chemical_list: D003287:Contrast Media