The Significance of Exploration of Retroperitoneal Hematoma Following Penetrating Trauma
Abstract
ABSTRACT
Background:
As retroperitoneal hematoma (RH), is a problem frequently encountered in the surgical practice; in a proportion of patients a RH is incidentally discovered at exploratory laparotomy.
Objectives: To evaluate the exploration of RH during explorative laparotomy for the penetrating trauma
Methods: Prospective study includes 220 patients found to have a retroperitoneal hematoma (RH) at laparotomy for penetrating trauma over six years period from January 2005 to April 2011. They were 157 males (71.3%) and 63 females (28.6%). their ages ranged from 6-66 years, mean (± SD) 36 (± 30) year
Results: In type I (central) RH; 33 patients (70.2%) there was active hemorrhage associated with RH; in 14 patients (29.7%); the RH was stable. Associated injuries were treated on their merits. Thirty-three patients were admitted in profound shock. Type II (flank) RH: in 83 patients (56.4%) the RH was explored. Thirty-one (21.08%) patients had hematuria at the time of presentation to hospital. Type III (pelvic) RH. Total 26 patients (11.8%) in all patients the RH were explored. Nine patients (34.6%) were active bleeding found at time of operation.
Conclusions: In conclusion type I and type III RH should be routinely explored. Stable type II RH discovered at laparotomy should be explored selectively based on preoperative clinical and radiological assessment of renal injury, i.e. RH without obvious active hemorrhage is not opened.
Copyright (c) 2012 Iraqi Medical Journal
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