The diagnosis and treatment of traumatic retroperitoneal hematoma

Objective: To analyze our experiences in patients with traumatic retroperitoneal hematoma, and highlight the problems in diagnosis and treatment to facilitate the surgeons to make decision. Methodology: One hundred and eight patients of traumatic retroperitoneal hematoma treated in our institution from May 2008 to Jun 2012 were reviewed retrospectively. The data including patient's age, type of injury, hospital stays, type of treatment, injured organs and mortality rate were collected. Results: In 108 patients, seventy-seven patients were male and 31 were female with a mean age of 36.5 years; eighty-seven patients sustained blunt trauma and 21 penetrating injury. Centro-medial hematoma was found in 31 patients, lateral hematoma in 36 patients, pelvic hematoma in 35 and pelvic-central hematoma in six patients. Eighty-three patients were treated surgically and 25 patients were treated conservatively. Six patients died and the mortality rate is 6.5%. Wound infection occurred in five patients, deep vein thrombosis in one patient, gastric fistula in two patients and duodenal fistula in one patient. Conclusion: Traumatic retroperitoneal hematoma is life-threatening condition, early diagnosis and correct treatment is of upmost importance. Mandatory exploration should be performed in cases of retroperitoneal hematomas resulting from penetrating injury, but the selection of treatment mode in blunt injury depends on the anatomical position of hematoma, visceral injury and the hemodynamic status of the patients.