MANAGEMENT OF RETRO PERITONEAL HAEMATOMA

Abstract

Objectives: To find out the frequency of different visceral injuries and
morbidity and mortality related to different zones in retro peritoneal haematoma due to trauma. Place of study: D.H.Q
Teaching Hospital Rawalpindi. Study Design: Prospective study. Duration of study: June 1998 to May 1999.
Results: There were total 45 patients with retro peritoneal haematoma. The policy for exploration of retro peritoneal
haematoma included mandatory exploration of Zone I and selective exploration of Zone II and III. Out of total 45
patients, 40 had associated intra peritoneal injuries and Zone I was most commonly involved (n=21) followed by Zone
II (n=13) & Zone III (n=11). Vascular, genitourinary and pelvic fracture injuries were the common injuries. Overall
mortality was 6.5% mainly due to irreversible shock in patients with Zone I vascular injuries. Conclusion: Mandatory
exploration of Zone I and selective exploration of Zone II & III is a valid policy in the management of retro peritoneal
haematomas. Penetrating Zone I trauma causing vascular injuries is most common of all. Shock is the most common
presentation, complication and cause of mortality.