ABSTRACT
The pelvis and groin contain a complex web of blood vessels. Given the magnitude of resection often needed when treating pelvic malignancies, it is not uncommon to be faced with the need to address major vascular issues. These fall into three general categories: inadvertent injuries requiring repair; planned resection as part of tumor excision, requiring reconstruction; and use of inferior vena cava filters to reduce the risk of fatal pulmonary embolism. Whenever major vascular hemorrhage is encountered, simple measures to initially control hemorrhage should be employed expeditiously. Initial attempts at repair may result in increasing the risk of further injury at the cost of significant blood loss. In general, apply direct pressure at the site of bleeding to control hemorrhage and consult a surgeon with experience in vascular reconstruction. Preservation of life should always take priority over preservation of blood flow to limbs.
