Angiography should be considered in a patient with pelvic trauma if certain findings are present.
Patient selection: pelvic trauma
Indications:
(1) based on pattern of blood loss
(2) objective evidence of a large pelvic hematoma
(3) findings on imaging studies
Pattern of blood loss:
(1) obvious and rapid blood loss, requiring transfusion of > 4 units of blood within 24 hours
(2) intermittent or slow blood loss, requiring transfusion of > 6 units of blood within 48 hours
(3) hemodynamic instability and other evidence for significant blood loss, with a negative examination (peritoneal lavage, FAST) of intra-abdominal hemorrhage
Objective evidence:
(1) large and/or expanding pelvic hematoma found during laparotomy
Imaging Studies:
(1) large pelvic hematoma on CT scan or other imaging study
(2) intra-pelvic pseudoaneurysm found on helical CT
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