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Anal Necrosis Following Pelvic Crush Injury

John S.Berry MD, Alfred F. Trappey MD, Joseph L. Petfield MD, Julia M. Greene MD, Katherine Markell MD

Julia Greene, November 28, 2012

Arterial haemorrhage within the pelvic circulation can be controlled by nonselective embolization. However, complications are associated with distal ischemia from disruption of the aortoiliac circulation. Reported complications of pelvic crush injury include impotence, lower extremity nerve deficits, left colon ischemia, spinal cord injury, and necrosis of the rectum and gluteal musculature. We report a case of anal canal necrosis after a pelvic crush injury attributed to hypotension, compression by pelvic hematoma, and arterial disruption after selective unilateral transcatheter arterial embolization (TAE).

An Iliac Nutrient Foramen Bleed in The Delayed Revision of an Acetabular Fracture

Jianshun Wang, November 18, 2011

Despite the challenges of delayed revision of acetabular fractures, severe haemorrhage leading to haemodynamic instability is not often encountered. Immediate intraoperative detection and cessation of the bleeding source is vital. We present a case highlighting an iliac nutrient foramen haemorrhage which almost resulted in a lethal haemorrhage during an open reduction of a delayed ace tabular fracture via the ilioinguinal approach.

C-spine fractures following falls in older patients

The importance of history taking and clinical suspicion

Ben Hickey, October 05, 2008

This case highlights the importance of the history and high index of suspicion of c-spine fracture older patients following falls.