Clinical spectrum, risk factors, management and outcome of patients with retroperitoneal hematoma: a retrospective analysis of 3-year experience

Abstract

ABSTRACT Objective Retroperitoneal Hematoma (RPH) is an underdiagnosed and overlooked disease entity and has a high mortality rate if not diagnosed in a timely manner. This study aims to analyze the clinical characteristics, risk factors, treatment and the outcome of RPH cases at our medical center. Methods In this retrospective study, all cases who presented to the emergency room (ER) and/or admitted to our center with the diagnosis of RPH from Jan 2016 to Dec 2018 were included (3-year data). Results A total number of 78 RPH cases were included including both the traumatic and spontaneous bleed. The most common setting was spontaneous bleeding with no concurrent use of anti-thrombotic agents. Zone 3 (pelvic hematoma) bleed was the most common type of RPH. Most patients were successfully managed medically alone (59%). Others required surgical intervention, either laparoscopy, laparotomy or through the interventional radiological approach. There was a significant association between the need for vasopressors (OR-5.65, P-value of 0.039), spontaneous bleed (P-value of 0.001), bleed without antithrombotic agents (P-value of 0.002) with prolonged hospital stay (> 5 days). On follow-up, 83% of cases were reported to be alive. Only 2 patients died secondary to hemorrhagic shock. Conclusion Most cases of RPH had an excellent outcome with conservative management alone.