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Abstract
Fifty patients with major fractures of the pelvis (Trunkey's classification types
I and II) treated in an urban Level I Trauma Center were analysed to assess the role
of peritoneal lavage and urological studies in the initial evaluation. The mechanisms
of injury were automobile v. pedestrian (44 per cent), falls from heights (44 per
cent), and motor vehicular accidents (12 per cent). Important hypotension was present
in 46 per cent of patients on arrival. Peritoneal tap or lavage was selectively used
in 11 patients (22 per cent). Four patients in refractory hypotension despite vigorous
resuscitation had positive results. There were no false-positive results or missed
intra-abdominal injuries in any of the 50 patients. Laparotomy was carried out in
10 of 50 patients. IVP or cystography was performed in 25 of 50 patients. However,
injuries of the urinary tract requiring operative correction (eight injuries in six
patients) were all associated with gross haematuria. Urological studies were negative
in patients with 1 to 3+ microscopic haematuria. Peritoneal lavage is recommended
on a selective basis in patients with pelvic fractures. Microscopic haematuria does
not warrant contrast studies of the urinary tract.
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Article info
Publication history
Accepted:
January 22,
1987
Footnotes
☆Presented to the New York Surgical Society Meeting, 13 November 1985.
Identification
Copyright
© 1987 Published by Elsevier Inc.
