2013
DOI: 10.1186/1757-7241-21-82
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Comparison between laparotomy first versus angiographic embolization first in patients with pelvic fracture and hemoperitoneum: a nationwide observational study from the Japan Trauma Data Bank

Abstract: BackgroundA common dilemma in the management of pelvic fractures is recognizing the presence of associated abdominal injury. The purpose of this study was to determine the association between initial therapeutic intervention (laparotomy or transcatheter arterial embolization (TAE)) and mortality.MethodsThis was a cohort study using the Japan Trauma Data Bank between 2004 and 2010, including blunt trauma patients with pelvic fractures and positive Focused Assessment with Sonography in Trauma (FAST) results. Eli… Show more

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Cited by 26 publications
(24 citation statements)
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References 27 publications
(36 reference statements)
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“…Current treatment strategies use these options in combination; however, the optimal treatment approach remains a subject of debate . Transcatheter arterial embolization is a rapid and established technique for controlling intractable hemorrhage in pelvic fractures . In our patient, the hemodynamic instability suggested ongoing bleeding, although initial contrast‐enhanced CT revealed retroperitoneal hematoma without contrast extravasation.…”
Section: Discussionmentioning
confidence: 82%
See 2 more Smart Citations
“…Current treatment strategies use these options in combination; however, the optimal treatment approach remains a subject of debate . Transcatheter arterial embolization is a rapid and established technique for controlling intractable hemorrhage in pelvic fractures . In our patient, the hemodynamic instability suggested ongoing bleeding, although initial contrast‐enhanced CT revealed retroperitoneal hematoma without contrast extravasation.…”
Section: Discussionmentioning
confidence: 82%
“…The treatment options for pelvic fracture hemorrhage include TAE, external fixation, and preperitoneal pelvic packing. Current treatment strategies use these options in combination; however, the optimal treatment approach remains a subject of debate . Transcatheter arterial embolization is a rapid and established technique for controlling intractable hemorrhage in pelvic fractures .…”
Section: Discussionmentioning
confidence: 99%
See 1 more Smart Citation
“…[ 5 12 13 ] Recent studies have been unable to measure a difference in mortality between surgical packing and angiographic intervention. [ 20 21 25 ]…”
Section: Discussionmentioning
confidence: 99%
“…However, the appropriate acute management of hemodynamically unstable patients with pelvic fractures remains controversial. Arterial embolization (AE) and preperitoneal pelvic packing (PPP) are the commonly used procedures in this setting, although there is no conclusive evidence regarding the superiority of either procedure [2,4,5].…”
Section: Introductionmentioning
confidence: 99%