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Retropretonieal_Hematoma:
Bleeding within the retropretonieal space.
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Causes:
1)Trauma: pancreas, kidneys, major vessels and colon.
2) Procedures (Iatrogenic): Femoral catheterization in PCI.
3)Medications: Anticoagulants and antiplatlets.
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Clinical_manifestion:
Hx: trauma, medications and PCI.
Ex: obvious injury, signs of shock, Cullen's and Grey turner sign.
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Classification:
Anatomically 1) ZONE-I (#Central) :area injury usually involves the pancreas, duodenum and major vesseles.
2)ZONE-II (#Lateral): involved organs include genitourinary organs and the colon.
3)ZONE-III (Pelvic) : iliac and femoral vessels, femoral veins and pelvic fracture are the source of the hematoma in this zone.
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DDX:
1) Retoperitoneal tumor.
2)Retoperitoneal abscess.
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Dx: CT + clinical.
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Managment:
Supportive (IV hydration and blood transfusion) +
1) ZONE-I : always surgical.
2) ZONE-II : surgical penetrating or rabidly increasing in size.
3) III: if penetrating surgical.
#Reference:
1)Current surgical diagnosis and Tx
