図４〜図６で腸骨骨折（↑）があり，周辺に血腫があり（※），膀胱を左方へ圧排している．図１０〜図１２で寛骨臼の骨折を認める（白矢印）．図８と図９の▲は，下段のウィンドウ幅を広げた（2000HU）骨組織用のCT図１１と図１２で大腿動脈のdensityより高く（▲），骨片である．図７と図８の△は，尿管がまだ描出されていない時期のCTだから膀胱内尿ではなく，膀胱外所見であり，extravasationの可能性が高い．血管造影でextravasationを認め（図Ａ：△），コイルで塞栓し（図B）止血に成功した．

文献考察：両側内腸骨動脈塞栓術
J Trauma. 2004 Apr;56(4):734-9; discussion 739-41.
Male sexual function after bilateral internal iliac artery embolization for pelvic fracture.
Ramirez JI, Velmahos GC, Best CR, Chan LS, Demetriades D.

BACKGROUND: Bilateral internal iliac artery embolization (BIIAE) effectively controls unlocalized bleeding from pelvic fractures. Its short-term safety has been documented, but its long-term effect on urogenital function has not been evaluated. METHODS: Patients having temporary BIIAE with gelatin sponge slurry for pelvic fractures were prospectively identified. Two control groups were created--one with similar pelvic fractures but no embolization, and the other with nonpelvic injuries. The groups were matched for risks of urogenital dysfunction: age, time elapsed since injury, Injury Severity Score, pelvic Abbreviated Injury Scale score, and presence of urethral or bladder injuries. Urogenital function was assessed at least 1 year after injury using a validated questionnaire. RESULTS: Sexual function was significantly compromised in patients having pelvic fractures compared with those not having fractures. There was no difference in sexual function between patients having pelvic fractures treated with BIIAE and those having pelvic fractures alone. CONCLUSION: BIIAE does not produce lasting adverse effects on urogenital function. Sexual dysfunction frequently occurs after traumatic pelvic fracture and is produced by the injury itself.PMID: 15187735
追記：著者らはgelatin spongeで両側の内腸骨動脈塞栓術を勧めている．gelatin spongeは数時間〜数日で溶解し血管は再開通するので男性の性機能不全の原因にはならない．両側の内腸骨動脈を塞栓することで骨盤腔の血流を減少させ，静脈系の出血にも効果がある．