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Postgraduate Medical Journal 2006;82:e25; doi:10.1136/pgmj.2006.047381
Copyright © 2006 The Fellowship of Postgraduate Medicine

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CASE REPORT

Massive haemorrhage after a low-energy pubic ramus fracture in a 71-year-old woman

D J M Macdonald 1, C J Tollan 2, I Robertson 3, B S Rana 4

1 Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK
2 SHO II Plastic Surgery, Glasgow Royal Infirmary, Glasgow, UK
3 Consultant Radiologist, The Department of Radiology, Gartnavel General Hospital, Glasgow, UK
4 Department of Orthopaedic Surgery, Western Infirmary, Glasgow, UK

Correspondence to:
Correspondence to:
C J Tollan
SHO II Plastic Surgery, Glasgow Royal Infirmary, Flat 3/1, 4 Dudley Drive, Glasgow G12 9SD, UK;cj_tollan{at}hotmail.com

We describe a case of a patient receiving warfarin who presented with a superior pubic ramus fracture after a trivial fall at home. She developed a massive retroperitoneal haematoma as a result of vascular injury and subsequently died. This case emphasises the importance of admitting and observing patients with pubic rami fractures who are receiving antithrombotic treatment, and haemorrhage should be considered if they become haemodynamically compromised.








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