図１で右側の恥骨及び坐骨骨折（↑）を認め，CTでは図１５の白矢印が骨折部である．骨盤腔内には大量の血腫があり，early phaseの図８〜図１４で血腫内に認められる高吸収域：△はdelayed phaseの図５〜図１７では▲で示すように大きく拡散・拡大し，extravasation（活動性出血）を示している．血管造影でextravasationが2ヶ所（図A：△）認められたため内腸骨動脈起始部を塞栓し（図B：▲），止血に成功した．このように一見軽傷に見える安定型の損傷でも大出血を伴うことがあるので注意を要する．

文献考察：高齢者の骨盤損傷は出血量が多く重症化する．
J Trauma. 2002 Jul;53(1):15-20.
Pelvic fracture in geriatric patients: a distinct clinical entity.
Henry SM, Pollak AN, Jones AL, Boswell S, Scalea TM.

BACKGROUND: The purpose of this study was to describe differences in demographics, injury pattern, transfusion needs, and outcome of pelvic fractures in older versus younger patients. METHODS: This was a retrospective registry review of all patients with pelvic fractures admitted directly from the scene between January 1998 and December 1999. RESULTS: We cared for 234 patients with pelvic fractures during the study period. Mean age was 37.2 years, 51% were men, and mean Injury Severity Score (ISS) was 19. Overall mortality was 9%. Eighty-three percent were under the age of 55 years and 17% were older than 55 years. Severe pelvic fractures (AP3, LC3) were more common in young patients (p