Large Retroperitoneal Hematoma in Surgery — 28yo Man | Trauma Surgery | SMLE Q#16979
SMLE Question #16979
Surgery
Trauma Surgery
Objective: OBJ-TRM-AIRWAY-01
Last updated: February 2026
A 28-year-old man is brought to the emergency department after a high-speed motor vehicle collision. He was a restrained driver and has severe pelvic and lower abdominal pain. He is pale and diaphoretic. FAST is negative for free intraperitoneal fluid. Trauma CT shows multiple pelvic fractures with a large retroperitoneal hematoma and no solid-organ injury. He remains hypotensive despite an initial crystalloid bolus. What is the most appropriate next step in initial management?
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