• Am J Emerg Med · Nov 2012

    Case Reports

    Delayed presentation of hypovolemic shock after a simple pubic ramus fracture.

    • Cheuk-Kwan Sun, Wai-Ming Kong, and I-Ting Tsai.
    • Department of Emergency Medicine, E-Da Hospital, I-Shou University, Kaohsiung, Taiwan.
    • Am J Emerg Med. 2012 Nov 1;30(9):2090.e1-4.

    AbstractAlthough trauma-induced simple pubic ramus fracture is common in the emergency department (ED), it can result in life-threatening hemorrhagic shock. We describe a 58-year-old woman with closed minimally displaced simple pubic ramus fracture. Hemodynamic instability became apparent 2 hours later. She was successfully treated with transarterial embolization and discharged uneventfully 10 days later. Literature review showed involvement of the superior pubic ramus in all reported cases probably because of hemorrhage from “corona mortis” with delay in shock presentation mostly within 6 hours, suggesting at least an equivalent observation period for these patients, particularly those at high risk for hemorrhage.

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