Hemodynamic Instability associated with pelvic fracture
Evers Cryer Miller, Arch Surg 124 422 I989, University of Kentucky, Louisville, 245 consecutive pelvic fxs
Supraumbilical diagnostic peritoneal lavage was grossly positive in 27 patients. 30% of these had life threatening intraperitoneal hemorrhage (8). No pt with positive DPL by count alone had life threatening intraperitoneal hemorrhage.
Early pelvic ex fix pts required (10 ± 1 U ) blood while MAST trousers required (17±3 U). 9 patients with pelvic arterial bleeding underwent angiographic embolization with 8/9 deaths in that group. Authors rec angios before lap in hemodynamically unstable group unless the DPL is grossly positive.