A 25-year-old man is brought in by ambulance having been found on the side of a motorway after a presumed pedestrian vs car accident. He describes extreme pelvic and suprapubic pain and an open left tib/fib fracture. A pelvic binder was placed pre-hospital

He is haemodynamically unstable with HR 140, BP 85/50 and appears very pale. He received massive transfusion protocol in emergency with 7x PRBC, 2x FFP and 2x cryoprecipitate.

EFAST is positive, with free fluid in his pelvis.

A large perineum wound from scrotum to the anus required packing while in the ED to achieve haemostasis.

A Pelvic X-Ray is performed in the trauma bay

CT Case 053 001

Describe and interpret the X-Ray

Pelvic X-Ray interpretation

Following transfusion he was stable enough to be taken to CT.

Describe and interpret the CT scan

CT interpretation

Clinical Pearls


Emergency Medicine Education Fellow at Liverpool Hospital NSW. MBBS (Hons) Monash University. Interests in indigenous health and medical education. When not in the emergency department, can most likely be found running up some mountain training for the next ultramarathon.

Dr Leon Lam FRANZCR MBBS BSci(Med). Clinical Radiologist and Senior Staff Specialist at Liverpool Hospital, Sydney

Sydney-based Emergency Physician (MBBS, FACEM) working at Liverpool Hospital. Passionate about education, trainees and travel. Special interests include radiology, orthopaedics and trauma. Creator of the Sydney Emergency XRay interpretation day (SEXI).

Provisional fellow in emergency radiology, Liverpool hospital, Sydney. Other areas of interest include paediatric and cardiac imaging.

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