Introduction: A haemodynamically unstable patient with abdominal injury associated with pelvic fractures is a serious challenge for trauma surgeons and anesthesiologists. The purpose of this study is to evaluate the efficiency of patients’ treatment with combined abdominal-pelvic lesions using the TRISS and ASCOT predictive scores.
Patients and methods: The study included polytraumatized patients with haemodynamic instability or signs of acute abdomen witch required emergency laparotomy. Between 2008 and 2010, 124 patients were operated for abdominal trauma, 12 cases (9.6%) being associated with pelvic fracture.
Results: The mean age was 50.1 years (range 25–80 years).The lesions associated with pelvic fractures were the following: rupture of spleen (2 cases), liver rupture (2 cases), lung rupture (2 cases), diaphragm rupture and detachment (3 cases), small intestine and colon lesions (3 ca-ses), rupture of the urinary bladder (4 cases), urethra rupture (3 cases), and head trauma (3 cases). In the treatment of retroperitoneal bleeding in 6 cases it was necessary to perform packing control of the pelvic haemorrhage. Four patients died, giving an overall mortality rate of 33.3%. The mortality was not influenced by age (p = 0.31), ISS (p = 0.42) and pH (p = 0.63). The probability of survival calculated using TRISS was 62.3% and the probability of death calculated using ASCOT was 28.6%.
Conclusions: The control of haemostasis and peritoneal decontamination are priorities in the case of adominal-pelvic lesions. The packing control of haemorrhage proved to be effective in the management of bleedings caused by rupture of a retroperitoneal hematoma in the peritoneal cavity.