שאלה משלב א׳ בכירורגיה אורולוגית · מועד 2022, שאלה 101

Correct: B — if the pelvic radiograph shows a pelvic fracture, a pelvic binder should be applied. A persistently hypotensive patient after a crush injury to the pelvis is bleeding into the pelvis until proved otherwise, and the binder is the immediate, cheap, pre-radiological measure that reduces the fracture, decreases the pelvic volume and restores tamponade. It works on *venous* and cancellous bone bleeding by mechanical tamponade and does not control arterial haemorrhage (option C), which is what angioembolisation is for — the reverse of option D. CT is not the first examination in a patient who remains hypotensive after fluid resuscitation (option A).

מקור: ch.16 עמ ' 445 – צד ימין פסקה2 ואיור16-30 ch.17 p. 425 איור 17.31 . p.424 צד ימין פסקה3