Management of retroperitoneal haematoma

To find out the frequency of different visceral injuries and morbidity and mortality related to different zones in retro peritoneal haematoma due to trauma. D.H.Q Teaching Hospital Rawalpindi. Prospective study. June 1998 to May 1999. 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] and 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. Mandatory exploration of Zone I and selective exploration of Zone II and 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