TY - JOUR T1 - Management of bladder neck injury after complex pelvic fracture JF - Trauma Surgery & Acute Care Open JO - Trauma Surg Acute Care Open DO - 10.1136/tsaco-2022-001033 VL - 7 IS - 1 SP - e001033 AU - Gregory R Stettler AU - Amy N Hildreth AU - J Jason Hoth AU - Samuel P Carmichael II Y1 - 2022/10/01 UR - http://tsaco.bmj.com/content/7/1/e001033.abstract N2 - A 59-year old woman presented to the emergency department (ED) after sustaining injuries in a head-on motor vehicle collision. A supraglottic airway was placed in the field secondary to a depressed Glasgow Coma Scale score and airway protection. The patient initially presented to the ED with hemodynamic instability, as defined by tachycardia (153 beats/min) and hypotension (87/67 mm Hg). During the primary and secondary surveys, the supraglottic airway was exchanged for an endotracheal tube; a left-sided chest tube for large pneumothorax was placed; the pelvis was sheeted; and the patient received whole blood. Following these interventions, her heart rate was 87 beats/min with a blood pressure of 106/81 mm Hg. Focused assessment with sonography for trauma exam was positive for fluid in the right upper quadrant. Physical examination was significant for crepitus along the left chest wall, and venous oozing was identified from a vaginal laceration. Pelvic radiography showed multiple pelvic fractures.CT imaging was performed, which revealed multiple left-side rib fractures, small volume intraperitoneal fluid layering in right paracolic gutter and complex pelvic fractures with a decompressed bladder (figure 1). Given these constellation of findings, there was … ER -