Injury to the bony pelvis carries a significant mortality and morbidity. Disruption of the retroperitoneal arteries and venous plexus with compromise of pelvic ring integrity can lead to massive blood loss. When combined with an abdominal vascular or solid organ injury, with a patient presenting in haemorrhagic shock, mortality approaches 100% in some series. Management of these injuries is difficult and practices differ from institution to institution.

The symposium on the management of exsanguinating pelvic trauma was convened in response to a discussion on the trauma.org mailing list. The wide and disparate practices have prompted this review of practice and evidence. The main session was a moderated panel discussion between trauma surgeons, orthopaedic surgeons and interventional radiologists. Using multimedia presentations and audience interaction, the implications of these complex injuries was presented and management issues discussed. The symposium case can be reviewed on these web pages along with examination of the literature and discussion of the issues by the trauma-list email group.