Trauma-associated bleeding from the bilateral internal iliac arteries resolved with angiographic embolization

Pelvic fractures are traumas with high mortality. The management of major pelvic injuries is still one of the most important problems in modern trauma care. A 39-year-old male patient was brought to the emergency department after a 500-kg load fell on him. His general condition was average and vital findings were unstable. Pelvic tomography revealed fractures in the bone structures, thickening secondary to hematoma in both iliopsoas muscles and hemorrhage-related active extravasation in the left internal iliac trace.The patient’s hemodynamics worsened despite fluid and blood replacement, and angiographic embolization was scheduled and bilateral embolization of the iliac artery was performed. Control angiography revealed that full embolization had been established. The patient was sent for monitoring in intensive care, but was lost on the third day of monitoring due to acute kidney failure, disseminated intravascular coagulation and multi-organ failure. Angiographic embolization is a technique that yields successful results in term of hemorrhage control in pelvic trauma, but that can also involve complications such as ischemia and necrosis.