Bladder necrosis secondary to internal iliac artery embolization following pelvic fracture

ABSTRACT

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