Abstract

The management of retroperitoneal hematomas remains to be confusing to many surgeons because it often does not correlated well with the underlying mechanism of injuries and the treatment may differ considerably. So we reviewed 70 patients who had been admitted due to traumatic retroperitoneal hematomas at Young Dong Severance Hospital, Yonsei University College of Medicine from January 1986 to December 1990. 70 patients had retroperitoneal hematoma among 260 who had sustained abdominal trauma (blunt injury: 180, penetrating injury: 80). The most common cause was pedestrianauto accident who accounted 33 patients. According to Selivanov, the retroperitoneal hematoma is classified as Zone I (central), II (flank) and III (pelvic). In our series, the Zone I retroperitoneal hematoma consisted 18.6%, Zone II 31.4% and Zone III 58.6% ; the pelvic bone fracture was the most frequently implicated with retroperitoneal hematoma. Exploratory laparomy was performed in 27 patients and 43 patients were treated conservatively. 24 patients had hypovolemic shock at the emergency room and 5 of them expired (mortality rate: 20.8%). 12 patients required 6-15 units of blood and 3 of them died (mortality rate: 25%). 5 patients rquired more than 16 units of blood and 2 died (mortality rate: 40%). 14 patients recieved ventilatory care for more than 24 hours and 5 died. The overall mortality rate was 8.6% (6 out of 70).