Duodenal obstruction by retroperitoneal hematoma induced by severe blunt renal trauma.

Abstract

Blunt trauma is the most common cause of renal injury. Of renal injuries 85% are classified as minor, corresponding to grades I to II on the organ injury scale, and are treated conservatively.1 Major renal injuries (grades III to V) represent the remaining 15% of cases and management remains controversial.1, 2 Perirenal and/or retroperitoneal hemorrhage is a common complication of renal trauma. Significant hypovolemia, abdominal tenderness, adynamic ileus, tender palpable mass and bluish discoloration of the flank are signs of retroperitoneal hemorrhage. In our patient major right renal injury resulting in a huge retroperitoneal hematoma was treated conservatively. However, obstruction of the second portion of the duodenum by the retroperitoneal hematoma developed 16 days after trauma. To our knowledge obstruction of the duodenum induced by severe retroperitoneal hematoma has not been reported in patients with major renal trauma, al-