Pelvic Fractures and Associated Genitourinary and Vascular Injuries: A Multisystem Review of Pelvic Trauma

AJR Am J Roentgenol. 2019 Dec;213(6):1297-1306. doi: 10.2214/AJR.18.21050. Epub 2019 Oct 15.

Abstract

OBJECTIVE. Blunt pelvic trauma is associated with injuries to the musculoskeletal, lower genitourinary, and vascular systems, leading to significant morbidity and mortality. This article provides a comprehensive review of these injuries, reviews classification systems that are helpful in predicting prognosis, describes the most appropriate imaging tests for injury detection, and emphasizes the role that interventional radiology plays in the setting of pelvic trauma. CONCLUSION. Blunt pelvic injuries can involve the musculoskeletal, genitourinary, and vascular systems, often concomitantly, making it imperative for radiologists to recognize injury patterns and understand implications for management. Injury classifications can be helpful in determining management and predicting prognosis. Contrast-enhanced CT is the imaging modality test of choice in evaluating pelvic trauma, and protocols should be optimized for best detection of injuries. Transcatheter arterial embolization plays a critical role in stopping acute hemorrhage and improving clinical outcomes.

Keywords: genitourinary trauma; pelvic injury; trauma; vascular trauma.

Publication types

  • Review

MeSH terms

  • Fractures, Bone / complications*
  • Fractures, Bone / diagnostic imaging*
  • Humans
  • Pelvic Bones / injuries*
  • Urogenital System / diagnostic imaging*
  • Urogenital System / injuries*
  • Vascular System Injuries / diagnostic imaging*
  • Vascular System Injuries / etiology*
  • Wounds, Nonpenetrating / diagnostic imaging*