Differential Diagnosis of pelvic trauma induce urethral injury

Large number of cases indicated that urethral injuy usually following the pelvic fracture,

with anterior urethral. The other injury associated with pelvic fracture is another organ injury

surrounding the pelvic area including bowel entrapment, abdominal compartment syndrome, and

cancellous fracture.1,2

Bowel entrapment

Bowel entrapment after the pelvic fracture is rare and hard to diagnose. Bowel become entrapped

within a pelvic following the pelvic fractures. Bowel entrapment manifest as an acute intestinal

obstruction or intermittent ileus, usually hard to diagnose due to similarity to common paralytic

ileus. A CT scan with enteric contrast can demonstrate a herniated or entrapment bowel in the

fracture.1

Abdominal Compartment Syndrome

Abdominal Compartment Syndome occur when the intra abdominal pressure inside the

abdominal cavity is higher than 12 mmHg and there are specific organ failure. ACS is a rare case

following the pelvic fracture caused by internal bleeding in retroperitoneal, intraperitoneal,

parietal or intestinal.2

Cancellous bone fracture

Pelvic fracture usually doesn’t manifest with a massive bleeding, hemorrhage occur when there

are fractures on the cancellous bone in pelvic area that cause injury to small arteries or veins.

Most common arteries involve in the pelvic fracture is internal iliac artery, meanwhile the

diagnosis for external iliac artery injury is sometimes delayed If there is caudal displacement of
hemipelvic that disrupt the pelvic floor and vasculature more than a standard injury, the

physician must be aware of complication of external iliac artery injury and confirmed the

diagnosis by angiography.2

Daftar pustaka

1. McCromack R, Strauss E.J, Alwattar B.J, and Tejwani N.C. Diagnosis and Management

of Pelvic Fractures. Bulletin of the NYU Hospital for Joint Diseases. 2010;68(4):281-91

2. Zong Z.W, Bao W.Q, Liu H.Y, et al. Diagnosis and treatment of rare complications of

pelvic fractures. Chinese Journal of Traumatology . 2016;19(4):199-205.