Jayakumar Joanna E, Zaid Mohammad, Flayyih Raya, Ansari Ahmad Kamal, Kotiesh Kais, Saeedi Yaser
Surgery, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, ARE.
Urology, Dubai Health, Dubai, ARE.
Cureus. 2025 Apr 14;17(4):e82277. doi: 10.7759/cureus.82277. eCollection 2025 Apr.
Open book fractures frequently occur in road traffic accidents and are often associated with organ injuries, soft tissue damage, and urogenital trauma. Pelvic fractures can vary in severity, with some being stable and others involving significant structural disruption. A 32-year-old man presented with severe lower abdominal and right lower limb pain following a road traffic accident. He remained alert and denied loss of consciousness but exhibited tachycardia. Examination revealed lower abdominal tenderness, pelvic swelling, bruising, and a scrotal hematoma. CT imaging showed extensive pelvic fractures involving the sacral promontory and right sacral ala, along with bladder rupture and urethral injury. He underwent urgent pelvic external fixation and exploratory laparotomy with bladder repair. Postoperatively, he developed hypovolemic shock, requiring ICU admission, fluid resuscitation, and blood transfusion. Intensive monitoring and conservative management stabilized his condition, allowing for additional surgical procedures. Despite the severity of his injuries, he showed signs of recovery, with stabilized vital signs and reduced pelvic swelling. Continued medical and supportive care underscored the importance of timely and comprehensive management in severe pelvic trauma cases. Bladder trauma is a serious complication of pelvic injuries, ranging from minor contusions to complete rupture. These injuries require prompt recognition and surgical intervention. Damage often occurs due to force transmission to the bladder, especially when it is full, leading to increased pressure and potential rupture. Given its location near the pelvic bones, the bladder is at a higher risk of injury in severe trauma. Symptoms may include lower abdominal pain, swelling, bruising, and signs of circulatory distress. Imaging helps assess the extent of injury and guides surgical management. Timely intervention is essential to prevent complications such as infection and long-term dysfunction. A multidisciplinary approach, vigilant monitoring, and aggressive management of complications are key to optimizing recovery in complex pelvic trauma cases.
开放性骨盆骨折常发生于道路交通事故中，且常伴有器官损伤、软组织损伤和泌尿生殖系统创伤。骨盆骨折的严重程度各不相同，有些较为稳定，而有些则涉及严重的结构破坏。一名32岁男性在道路交通事故后出现严重的下腹部和右下肢疼痛。他神志清醒，否认失去意识，但表现出心动过速。检查发现下腹部压痛、骨盆肿胀、瘀斑和阴囊血肿。CT成像显示广泛的骨盆骨折，累及骶骨岬和右侧骶骨翼，同时伴有膀胱破裂和尿道损伤。他接受了紧急骨盆外固定和膀胱修补的探查性剖腹手术。术后，他出现了低血容量性休克，需要入住重症监护病房、进行液体复苏和输血。加强监测和保守治疗使他的病情稳定下来，从而能够进行进一步的外科手术。尽管他伤势严重，但仍有恢复迹象，生命体征稳定，骨盆肿胀减轻。持续的医疗和支持性护理凸显了在严重骨盆创伤病例中及时和全面管理的重要性。膀胱创伤是骨盆损伤的严重并发症，范围从轻微挫伤到完全破裂。这些损伤需要及时识别和手术干预。损伤通常是由于力量传递到膀胱，尤其是当膀胱充盈时，导致压力增加和潜在破裂。由于膀胱位于骨盆骨附近，在严重创伤中受伤风险较高。症状可能包括下腹部疼痛、肿胀、瘀斑和循环窘迫迹象。影像学有助于评估损伤程度并指导手术管理。及时干预对于预防感染和长期功能障碍等并发症至关重要。多学科方法、密切监测和积极处理并发症是优化复杂骨盆创伤病例恢复的关键。
