title: Trauma-associated bleeding from the bilateral internal iliac arteries resolved using angiographic embolization.
abstract: Pelvic fracture is associated with high mortality. The management of major pelvic injuries remains one of the most important issues in modern trauma care. A 39-year-old male patient presented at the emergency department after being hit with a 500 kg load. His general condition was average with unstable vital signs. Pelvic tomography revealed fractured bone structure, thickening secondary to hematoma in both iliopsoas muscles, and hemorrhage-related active extravasation in the left internal iliac trace. The patient's hemodynamics worsened despite fluid and blood replacement, and angiographic embolization was scheduled. Bilateral embolization of the iliac artery was performed. Control angiography confirmed that full embolization was established. The patient was monitored in intensive care, but expired after three days due to acute kidney failure, disseminated intravascular coagulation, and multi-organ failure. Angiographic embolization is a technique improves hemorrhage control in pelvic trauma but can also increase risk of complications such as ischemia and necrosis.
authors.affiliation: Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey. dr_aliaygun@hotmail.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Aygün
authors.affiliation: Department of Emergency Medicine, Kanuni State Hospital, Trabzon, Turkey.
authors.forename: Yunus
authors.initials: Y
authors.lastname: Karaca
authors.affiliation: Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Emin
authors.initials: E
authors.lastname: Ayan
authors.affiliation: Department of Emergency Medicine, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Türkmen
authors.initials: T
authors.lastname: Suha
authors.affiliation: Department of Radiology, Karadeniz Technical University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Hasan
authors.initials: H
authors.lastname: Dinç
mesh_terms: D000328:Adult; D000792:Angiography; D003937:Diagnosis, Differential; D004621:Embolization, Therapeutic; D050723:Fractures, Bone / Q000000981:diagnostic imaging / Q000601:surgery; D006406:Hematoma / Q000000981:diagnostic imaging / Q000628:therapy*; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000293:injuries*; D008297:Male; D009104:Multiple Trauma / Q000000981:diagnostic imaging / Q000628:therapy; D010384:Pelvic Bones / Q000000981:diagnostic imaging / Q000293:injuries*; D015641:Radiography, Interventional; D014057:Tomography, X-Ray Computed