J Trauma
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In this retrospective study, we reviewed our protocol for management of hemodynamically unstable patients with pelvic injury. ⋯ A protocol for management of patients with pelvic injury and hemodynamic instability that is associated with controlled resuscitation including vasopressor and early pelvic angioembolization is effective for treating pelvic hemorrhage and diagnosing extrapelvic hemorrhage. Further studies are needed to confirm the respective place of angiographic and surgical control of bleeding.
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After transcatheter angiographic embolization (TAE), massive gluteal muscle necrosis was found in patients during open reduction and internal fixation for pelvic fracture. ⋯ MRI revealed that TAE more frequently causes profound ischemic damage or necrosis than has been thought. This will be a warning to those who use TAE. Before definitive stabilization, external fixation may be recommended as a first-choice procedure for resuscitation and, then, unilateral selective TAE.