THE BLUNT ABDOMINAL TRAUMA AND PELVIC FRACTURES WITH HEMODYNAMIC INSTABILITY
Abstract:
The management of patients with hemodynamic instability related to pelvic fractures is a multidisciplinary challenge. The trauma surgeon, orthopedic surgeon and radiologist all have important roles to play in caring for these patients. Trauma patients with pelvic fractures and hemodynamic instability managed in the County Emergency Hospital Petroşani and Clinical County Emergency Hospital of Sibiu from 1990- 2013 were selectively analyzed. In this period, there were more than 1 2000 trauma admissions and 350 patients with pelvic fractures admitted with hemodynamic instability. If clinical and conventional X-ray examinations do not reveal any pathological findings, a major trauma can be excluded and further diagnostic measures postponed. After stabilization of the patients and if there is any suspicion, CT examination of the pelvis must be performed and also an abdominal ultrasound. Identifying the sites of hemorrhage and controlling the bleeding are key elements in managing pelvic fractures. Bleeding occurs from arteries, veins and cancellous bone. Rapid resuscitation, reversal of the acidosis and shock, with rapid control if possible of the hemorrhage are the key elements. External pelvic stabilization when appropriate, can be a useful adjuvant.
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