Temporary Arterial Balloon Occlusion of Internal Iliac Artery to Control Hemorrhage after Pelvic Trauma

Angiography has been widely used to identify the source of hemorrhage. Hemostasis with temporary balloon occlusion is used occasionally to control hemorrhage. This technique provides an effective and safe choice rather than surgical intervention. We report a 7-year-old girl with traumatic pelvic fracture. Massive vaginal bleeding developed on the 6th day of hospitalization. Hypovolemic shock was noted in spite of aggressive fluid challenge and blood transfusion. We were consulted to help stop the hemorrhage. The source of hemorrhage was confirmed by angiography under fluoroscopy. A balloon catheter was placed and inflated in the proximal portion of the anterior division of the left internal iliac artery. The hemorrhage was stopped successfully. The balloon catheter was removed the next day. There was no complication after this procedure. Therefore, temporary balloon occlusion should be considered as an alternative in emergent situation or when surgical intervention is technically not feasible.