Diagnosis and control of posttraumatic pelvic hemorrhage. Transcatheter angiographic embolization techniques.

Fourteen patients with posttraumatic pelvic hemorrhage underwent therapeutic transcatheter embolization of bleeding vessels. Six of them were victims of blunt trauma, six had penetrating trauma, and two had iatrogenic hemorrhage. Eleven patients had a celiotomy prior to angiographic embolization, and large retroperitoneal hematomas were evident in nine patients. Bleeding persisted postoperatively. It was initially controlled by embolization in all patients, but two rebled and were successfully reembolized. Two patients died because of traumatic injuries. There were no complications directly associated with the embolization procedures. Transcatheter embolization is a safe, effective method for controlling pelvic hemorrhage in patients with unstable or multiple pelvic fractures whose conditions fail to respond to more conventional forms of therapy.