Posttraumatic retroperitoneal rupture of the right colon simulating a retroperitoneal hematoma.

OBJECTIVE: This case illustrates the diagnostic problems encountered in a patient with posttraumatic retroperitoneal abscess caused by perforation of the posterior wall of the cecum, simulating a retroperitoneal hematoma. Because standard diagnostic techniques failed to make early diagnosis, delayed laparotomy and right colectomy with primary repair were performed. The mechanism of the lesion is uncertain but could be a compressive force and direct injury to the cecum by the seat belt. CONCLUSION: Blunt colonic injuries are rare and difficult to diagnose. Septic signs are unexpected in case of posttraumatic retroperitoneal hematoma and should suggest the diagnosis of retroperitoneal colonic perforation.