Bladder necrosis secondary to internal iliac artery embolization following pelvic fracture

• Main Authors: Ahmed Ali, Ghulam Nabi, Satchi Swami, Bhaskar Somani
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2014-01-01
• Series: Urology Annals
• Subjects: Bladder necrosis; embolization; internal iliac artery; pelvic fracture
• Online Access: http://www.urologyannals.com/article.asp?issn=0974-7796;year=2014;volume=6;issue=2;spage=166;epage=168;aulast=Ali
• ISSN: 0974-7796; 0974-7834

A 49-year-old man following a road traffic accident (RTA) had an unstable pelvic fracture with urethral injury. Internal pelvic fixation with Supra-pubic catheter (SPC) drainage of his bladder was done. This failed to stop the bleeding and a pelvic angiography with bilateral internal iliac embolization using steel coils was performed successfully controlling the bleeding. After 4 weeks, the patient developed wound infection (Clavien Grade III) and on exploration, bladder necrosis was found. A urinary diversion using ileal conduit with excision of bladder was performed. A biopsy of the excised bladder confirmed bladder necrosis with a foreign material (coil) in one arterial lumen.