Upper retroperitoneal injuries

Abstract

One hundred and ten cases of upper abdominal injuries have been reviewed. A significant proportion of them is retroperitoneal. It will be shown that an increased awareness of the importance of vague physical signs and the willingness to submit these patients to relevant investigations will result in an accurate diagnosis. A more logical and often vigorous approach to treatment has resulted in a dramatic reduction in the morbidity and mortality associated with such injuries.

Occult Aortic Injury after Penetrating Abdominal Trauma

“…Patients with retroperitoneal hematomas located in the central, upper abdomen (Zone 1), regardless of mechanism of injury, have a 65 per cent incidence of major vascular injury and should be explored. 3,4,11 In patients sustaining blunt trauma to the abdomen, actively expanding hematomas located in the paracolic regions (Zone 2) should be explored. As a general rule, pelvic hematomas (Zone 3) should not be explored in cases of blunt trauma, and are better addressed using angiography and embolization if active bleeding from this location persists.…”