ABSTRACT
Major disruptions of the pelvic ring are high energy injuries, frequently associated with multiple organ system injury and severe blood loss. Hypotensive patients with these fractures present a major challenge in diagnosis and treatment of the bleeding source; these patients require early and aggressive treatment by a multidisciplinary team. The optimal timing and indications for currently available diagnostic and therapeutic approaches remain controversial. Differentiating between intra-abdominal and intrapelvic bleeding is difficult. The treating surgeon, dealing with these injuries should understand the need for a multidisciplinary approach pelvic ring biomechanic of patterns of injury and principles of stabilization of these fractures. We describe a case of bilateral sacroiliac joint fracture dislocation and separation of the symphysis pubis, with major arterial bleeding, and intraperitoneal rupture of the urinary bladder