Citation

Rich C, Rayner J, Raukar N. Am. J. Emerg. Med. 2018; 36(2): 342.e1-342.e2.

Affiliation

Department of Emergency Medicine, Alpert Medical School of Brown University, United States. Electronic address: NRaukar@lifespan.org.

Copyright

(Copyright © 2018, Elsevier Publishing)

DOI

10.1016/j.ajem.2017.10.062

PMID

29150225

Abstract

We present a case of an elderly man who sustained non-displaced fractures through the right superior and inferior pubic rami after a fall from standing and had a tragic outcome. While minimally displaced pubic ramus fractures are typically stable and require only symptomatic treatment, there have been reports, such as this one, of low-energy pubic rami fractures resulting in massive hemorrhage. Despite aggressive resuscitation and embolization of the right obturator artery, our patient ultimately died during his hospitalization. This report highlights the need to maintain a high index of suspicion for intrapelvic bleeds even in patients with nondisplaced pubic rami fractures. Rapid recognition and treatment of intrapelvic bleeds can be lifesaving.

Copyright © 2017. Published by Elsevier Inc.

Language: en