Clinical Presentation

A 7-year-old boy struck by a car is brought to the emergency department.

Further Work-up

(A) Selected pelvic computed tomographic (CT) scan shows hematoma (arrow). (B) Selec ted pelvic angiogram shows teardrop-shaped bladder (arrow) compressed by hematoma. (C) Digital subtraction angiogram shows bilateral hemorrhage from the superior gluteal arteries (arrows). (D) Selected angiogram of the left internal iliac artery after coil embolization of the superior gluteal artery (arrow) shows additional focus of hemorrhage (arrowhead). (E) Pelvic angiogram after Gelfoam embolization of both internal iliac arteries shows no further extravasation.

Differential Diagnosis

• Pelvic trauma

Essential Facts