The common presentation is increasing abdominal pain. The patient with persistent elevation and abdominal symptoms requires further evaluation. The key is diagnosing and treating associated injuries and controlling pelvic blood loss. Assess antero-posterior and lateral stability. Unstable fractures and posterior fractures are associated with more hemorrhage than stable and anterior fractures.
Early objectives are to control hemorrhage.
Bony fixation reduces the long term morbidity. Embolization of an injured pelvic arterial branch may be life saving. Note that most bleeds are venous and will self-tamponade. The goals are to assess the severity of injury and protect from further damage. Protect from further insult by avoiding fluid overload and hypo or hypertension.