Current management of severe pelvic and perineal trauma - 17/08/12

Doi : 10.1016/j.jviscsurg.2012.06.004

C. Arvieux ^a,^⁎,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}} , F. Thony ^b,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, C. Broux ^c,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, F.-X. Ageron ^d,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, E. Rancurel ^e,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, J. Abba ^a,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, J.-L. Faucheron ^a,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, J.-J. Rambeaud ^f,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}, J. Tonetti ^g,^{^{1
All authors participate in the Northern Alps trauma system network project (Trauma system du Réseau Nord Alpin des urgences [TRENAU]). See complementary information at: www.renau.org/.}}
^a Clinique Universitaire de Chirurgie Digestive et de l’Urgence, Pôle Digi-DUNE, CHU A. Michallon, Grenoble, France
^b Clinique de Radiologie et Imagerie Médicale, Pôle Imagerie, CHU A. Michallon, Grenoble, France
^c Réanimation Polyvalente Chirurgicale, Déchocage – Bloc des Urgences, CHU A. Michallon, Grenoble, France
^d SAMU 74, CHR d’Annecy, Annecy, France
^e SAMU, Clinique SAMU–SMUR, Pôle Urgences, CHU A. Michallon, Grenoble, France
^f Clinique Universitaire d’Urologie et de Transplantation Rénale, Pôle Digi-Dune, CHU A. Michallon, Grenoble, France
^g Clinique Universitaire d’Orthopédie Traumatologie Nord, Pôle TCCR, CHU A. Michallon, Grenoble, France

Corresponding author. Clinique Universitaire de Chirurgie Digestive et de l’Urgence, CHU de Grenoble, BP 217, 38043 Grenoble cedex 09, France. Tel.: +33 4 76 76 92 80; fax: +33 4 76 76 58 02.

Summary

Mortality associated with pelvic and perineal trauma (PPT) has fallen from 25% to 10% in the last decade thanks to progress accomplished in medical, surgical and interventional radiology domains (Dyer and Vrahas, 2006) [1]. The management strategy depends on the hemodynamic status of the patient (stable, unstable or extremely unstable). Open trauma requires specific treatment in addition to control of bleeding. All surgical centers can be confronted some day with patients with hemorrhagic PPT and for this reason, all surgeons should be familiar with the initial management. In expert centers, management of patients with severe PPT is complex, multidisciplinary and often requires several re-interventions. Obstetrical and sexual trauma, also requiring specific management, will not be dealt with herein.

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Keywords : Pelvic trauma, Pelvic fracture, Hemorrhagic shock, Pelvic packing, Pelvic embolization

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Vol 149 - N° 4

P. e227-e238 - août 2012 Retour au numéro

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Current management of severe pelvic and perineal trauma - 17/08/12

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