The pelvic is fractured. Due to the difficulty to achieve haemorrhage control in pelvic trauma patients, prompt fluid replacement including blood is essential. Care should also be given to prevent hypothermia and coagulation impairment. These refer to specific maneuvers to limit or stop bleeding from pelvic fractures. Most of them aim to immobilize, fix, or close the broken pelvis, the rationale being that more than 90 percent of haemorrhage sources are from venous origin and they can be stopped by immobilization and alignment of the fracture sites.
Orthopaedic consultation is valuable.
If required, DPL should be performed above the umbilicus. DPL microscopically positive for blood should be carefully interpreted in patients with pelvic trauma, being possibly due to contamination of the lavage with blood from the extraperitoneal haematoma. Retrograde urethrograms before placement of the Foley catheter and cystograms after the placement may be essential. Female urethral lacerations most commonly occur with an anterior vaginal laceration. Posterior vaginal lacerations are commonly associated with rectal tears.