Seventy consecutive surviving patients with pelvic fractures were reviewed to 
define those at high risk for intra-abdominal injury. Eleven (16%) had serious 
associated visceral injuries. Initial hypotension, Malgaigne and bilateral pubic 
rami fractures, and blood requirements exceeding 2,000 cc were suggestive of 
abdominal trauma. These high-risk patients should undergo peritoneal lavage as 
an integral part of their initial management. If the lavage is negative, 
continued hemorrhage should be evaluated with angiography and nonoperative means 
of vascular control attempted before resorting to laparotomy.