1. Case 1 Farwaniya hospital

2. 36 y/o Male. Previously healthy. Brought to casualty by ambulance after being hit by a car.

3. Cons, alert, oriented. Complaining of – Abd pain – Right chest pain – Pelvic pain.

4. Vital sign GCS 15/15. A: maintaining airway. Spo 100% B: reduce A/E on r.side. C: BP 78/50 – P 112.

5. Resuscitated by IVF. BP 137/112. O/E: – Chest: good A/E bilaterally. – Tender, guarding all over his abd. – Genitalia + DRE normal. – No blood at EXT. uretheral meatus. Foly`s cath. : hematuria

6. Investiagtion FAST: peri-hepatic fluid collection. CBC: HB 15.9 – WBC 26- PLT 228. RFT: creat 68 – urea 1.1 Na 139 - k 3.5 LFT : Normal.

17. pelvis

19. CT showed - large pelvic hematoma (5x11x12cm) - pelvic fracture – Comminuted fracture of Lt. pubic bone – Inf. Pubic rami bilaterally - peri-hepatic free fluid ( no liver truma, no active bleeding)

20. Pt shifted to ICU -Pt prepared for surgery After 2 hours : Hb became 7.6. BP 100/70. Received 2 pints PRBC + 6 FFP. SHIFTED TO OT

21. Surgical exploration – Large bladder tear ( dome ) – 2 lacerations around bladder neck – repaired with 2 layer closure – No intervention from surgical side – SPC and drain were fixed – Drain removed after 2 days – SPC removed after 2 wks

23. Thank you for listening