Abstract
Sacral fracture has a high frequency of fatal shock when the internal vertebral venous plexus (Batson's venous plexus) around the spinal canal develops hemorrhage after damage by bone fragments. We report a case in which a microfibrillar collagen hemostat was used for hemorrhage in Batson's venous plexus ; we considered such a useful hemostatic method when other methods are ineffective. The patient was a 29-year-old man with an impalement injury at the perineal region caused by a steel column at the time of his fall. An emergency laparotomy with computed tomography was performed for intraabdominal hemorrhage due to sacral fracture. The intraoperative findings revealed that the steel frame was stuck into the sacrum (S1) of Denis Zone III. When the steel frame was removed, spurting hemorrhage was observed, which was assumed to have originated from Batson's venous plexus. After gauze packing and re-laparotomy 24 hours after the primary surgery, we achieved hemostasis by using the microfibrillar collagen hemostat in the bleeding site. For hemorrhage cases in Batson's venous plexus in the presence of hemostasis difficulty due to trauma, the use of a microfibrillar collagen hemostat can be one of the options.
