title: An unusual case of a patient who presented with haemorrhagic shock following massive subcutaneous haematomas of the lower back due to blunt trauma.
abstract: An 83-year-old woman with no significant medical history was transferred to our tertiary hospital after being hit by a car and presenting with haemorrhagic shock. Immediate fluid resuscitation was performed; physical, chest/pelvic X-ray and echographic examinations did not detect any major sources of bleeding. However, a contrast-enhanced CT scan revealed multiple regions of significant contrast extravasation in an extensive part of the subcutaneous tissue of the patient's lower back, which is an unusual source of bleeding. Transcatheter arterial embolisation of the lumbar and internal iliac arteries and their branches was carried out. In addition, haemostatic resuscitation was performed for damage control resuscitation, which successfully resolved the patient's haemorrhagic shock.
authors.affiliation: Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yumoto
authors.affiliation: Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan.
authors.forename: Keiji
authors.initials: K
authors.lastname: Sato
authors.affiliation: Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, Okayama, Japan.
authors.forename: Toyomu
authors.initials: T
authors.lastname: Ugawa
authors.affiliation: Department of Acute Care and Primary Care Medicine, Kawasaki Medical School Hospital, Okayama, Japan.
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ujike
mesh_terms: D000063:Accidents, Traffic; D000369:Aged, 80 and over; D019567:Back Injuries / Q000150:complications*; D004621:Embolization, Therapeutic; D005260:Female; D006406:Hematoma / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007083:Iliac Artery; D008159:Lumbar Vertebrae / Q000098:blood supply; D012151:Resuscitation; D012771:Shock, Hemorrhagic / Q000209:etiology* / Q000628:therapy; D040521:Subcutaneous Tissue / Q000293:injuries*; D014949:Wounds, Nonpenetrating / Q000150:complications*