Controversies in the management of retroperitoneal hemorrhage associated with pelvic fractures.

Pelvic fractures present major therapeutic challenge requiring systematic diagnostic and management strategies. This article describes a 50-year-old female with a massive pelvic fracture after being crushed under the wheels of a bus. All aspects of her management are presented in detail. The current indications and role of exploratory laparotomy, internal and external fixation, and diagnostic and therapeutic angiography are discussed.