Abstract
The present paper reports a case of severe pelvic fracture resulting in hemoperitoneum, hemothorax and cardiac tamponade. A 31-year-old woman was found unconcious after plunging from the third floor of a building in an attempted suicide. She was in shock and her blood pressure was 50 mmHg by palpation on arrival. Since roentgenography revealed pelvic fracture and bilateral leg fracture, and no other traumas were noted, she was diagnosed as having hemorrhagic shock due to pelvic fracture. On the 2nd day exploratory laparotomy was performed for suspected hemoperitoneum because her hemodynamic state was not stabilized by massive blood transfusion. Severe retroperitoneal hemorrhage and small amount of blood in the abdominal cavity, which was presumably exuded from the retroperitoneum, were found. On the 5th day the patient presented elevated CVP and tachycardia. Diagnosis of hemothorax and cardiac tamponade was made by chest roentgenography and echocardiography. Her hemodynamic condition became stable after a massive amount of bloody pleural fluid and bloody pericardial effusion was discharged by drainage of the thoracic cavity and drainage with pericardiotomy. As shown in the present case, patients with pelvic fracture tend to develop not only retroperitoneal hemorrhage but various pathological conditions. Therefore, careful management of their general condition, including respiration and circuration, as well as prompt and appropriate care, are required in addition to treatment of fracture.
