Bladder necrosis secondary to internal iliac artery embolization following pelvic fracture.
A 49-year-old man following a road traffic accident (RTA) had an unstable pelvic fracture with urethral injury. Internal pelvic fixation with Supra-pubic catheter (SPC) drainage of his bladder was done. This failed to stop the bleeding and a pelvic angiography with bilateral internal iliac embolization using steel coils was performed successfully controlling the bleeding. After 4 weeks, the patient developed wound infection (Clavien Grade III) and on exploration, bladder necrosis was found. A urinary diversion using ileal conduit with excision of bladder was performed. A biopsy of the excised bladder confirmed bladder necrosis with a foreign material (coil) in one arterial lumen.
Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK.
Ahmed
A
Ali
Ninewells Hospital Dundee and University of Dundee, Dundee, UK.
Ghulam
G
Nabi
Aberdeen Royal Infirmary, Aberdeen, UK.
Satchi
S
Swami
Department of Urology, University Hospitals Southampton NHS Trust, Southampton, UK.
Bhaskar
B
Somani
Bladder necrosis; embolization; internal iliac artery; pelvic fracture