Abstract
Retroperitoneal traumatic lesions are among the most challenging and serious emergencies, and necessitate a maximum of attention and expertise by the surgical team involved. Only with a careful judgment about the procedures to carry on it is possible to obtain valid results, which often means to safe the patients life. This is a prospective study, which included 30 patients with traumatic retroperitoneal hematoma, admitted to AL-Hussien Teaching Hospital for the period between Dec. 2017 – Nov. 2019 (22 months). They were analyzed regarding age, sex, type of trauma, signs and symptoms, relevant laboratory tests and radiological studies, operative findings, associated organ injured, methods of treatment, postoperative complications and their mortality rate. Most patients were males (77.2%). Young age group was more frequently injured (34.85%) of patients were in their third decade. Penetrating injury was the cause in majority of collected patients (83.3%). The commonest zone of retroperitoneal hematoma was zone 2 (74.24%) and the commonest site was the lateral perirenal hematoma. In conclusion; the presence of lesions on the retroperitoneum generally worsens the prognosis in traumatic pathology. All types of trauma, blunt or open, may involve retroperitoneal structures and organs. Associated abdominal organs injury may include the great vessels, pancreas, duodenum, oesophagus and genitourinary apparatus.
Highlights
The retroperitoneum is defined as the space between the posterior envelopment of the peritoneum and the posterior body wall
Hematoma in the area of the portal triad in the right upper quadrant is a cause to suspect the presence of injury to the portal vein or the hepatic artery or of vascular injury combined with an injury to the common bile duct
The presence of lesions on the retroperitoneum generally worsens the prognosis in traumatic pathology, it implies more attention and skills from both the medical and surgical aspect [9]
Summary
The retroperitoneum is defined as the space between the posterior envelopment of the peritoneum and the posterior body wall. Technically bounded anteriorly by the posterior reflection of the parietal peritoneum, the anterior extension of the retroperitoneum is quite convoluted, extending into the spaces in between the mesenteries of the small and large intestine [1,2]. Retrohepatic hematoma is a cause to suspect the presence of injury to the retrohepatic vena cava, a hepatic vein, or a right renal blood vessel. Symptoms and signs of a RPH are most commonly a reflection of the organs injured in the retroperitoneum rather than of the hematoma itself. The diagnosis of RPH is most difficult following blunt trauma to the abdomen and should be suspected in any patient following trauma who had signs and symptoms of hemorrhagic shock but no obvious source of hemorrhage. Blunt or open, may involve retroperitoneal structures and organs [10]
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