title: Emergency computed tomography for acute pelvic trauma: where is the bleeder?
abstract: Contrast medium extravasation at computed tomography (CT) is an accurate indicator of active haemorrhage in pelvic trauma. When this is present, potentially lifesaving surgical or endovascular treatment should be considered. Identification of the site or territory of haemorrhage is helpful for the interventional radiologist as it allows for focused angiographic evaluation and expedites haemostatic angio-embolisation. Even with thin-section arterial phase CT, tracing the bleeding vessel is not always possible and is often time consuming. We introduce a technique for predicting the bleeding vessel based on knowledge of the cross-sectional anatomical territory of the vessel as an alternative to tracing the vessel's course. Several case examples with digital subtraction angiography (DSA) correlation will be provided.
authors.affiliation: Department of Diagnostic Radiology, Tan Tock Seng Hospital, Novena, Singapore; Department of Diagnostic Radiology, National University Health System, 5 Lower Kent Ridge Road, 119074 Singapore. Electronic address: jim.hallinan@gmail.com.
authors.forename: J T P D
authors.initials: JT
authors.lastname: Hallinan
authors.affiliation: Department of Diagnostic Radiology, Tan Tock Seng Hospital, Novena, Singapore.
authors.forename: C H
authors.initials: CH
authors.lastname: Tan
authors.affiliation: Department of Diagnostic Radiology, Tan Tock Seng Hospital, Novena, Singapore.
authors.forename: U
authors.initials: U
authors.lastname: Pua
mesh_terms: D015901:Angiography, Digital Subtraction; D001158:Arteries / Q000473:pathology; D003287:Contrast Media; D003657:Decision Making; D004621:Embolization, Therapeutic / Q000379:methods; D004630:Emergencies; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000209:etiology / Q000628:therapy; D006470:Hemorrhage / Q000000981:diagnostic imaging* / Q000209:etiology / Q000601:surgery; D006801:Humans; D008297:Male; D010388:Pelvis / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000293:injuries; D014057:Tomography, X-Ray Computed; D014947:Wounds and Injuries / Q000150:complications / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media