RETROPERITONEAL HEMATOMAS

Retroperitoneal hematomas may occur after blunt and penetrating abdominal traumas and incidence differ in variable series. The management of retroperitoneal hematomas depends on the mechanism of the injury. During, periods of January 1990 and June 1995 with laparotomy retroperitoneal hematoma diagnosed 27 traumatized patients included in our story. 16 patients suffered from blunt and 10 patients penetrating trauma and in one patient there was spontane retroperitoneal hematoma. Mean age was 22, male/female ratio was 23/4, mean hospital stay was 12 days, mean operation time was 112 minutes. Retroperitoneal hematoma was located in Zone I in 4 cases. Zone II in 18 cases, Zone III in 4 cases, Zone I+HI in 1 case. 21 patients went under exploration during operation. In 5 cases isolate renal trauma, in 2 cases isolate pelvic fracture, in 1 case isolate urinary bladder trauma, and in 133cases multiple organ injury were the cause of the retroperitoneal hematoma. The therapy was related to the ethiology. In our study the overall mortality was 11% (3 cases ) and overall morbidity was 19% (5 cases). This study showed us the importance of choosing the therapy strategy according to the localization of the retroperitoneal hematoma.

RETROPERÝTONEAL HEMATOMLAR

Retroperitoneal hematomlar (RPH) künt ve penetran abdominal travmalardan sonra oluþabilir. Ýnsidans çeþitli serilerde deðiþiklik göstermektedir. 1 Ocak 1990 ile 1 Haziran 1995 tarihleri arasýnda SSK Ýstanbul Hastanesi acil cerrahi kliniðine baþvuran ve yapýlan laparotomide RPH saptanan 27 travmatize olgu bu çalýþma kapsamýna dahil edilmiþtir. Hastalarýn 16'sýnda künt, 10'unda penetran yaralanma vardý.1 hastada da spontan retroperitoneal hematom mevcuttu. Hastalarýn yaþ ortalamasý 22, erkek/kadýn oraný 23/4 idi. Ortalama hastanede kalýþ süresi 12 gün, ortalama operasyon süresi 112 dk. idi. Hematom 4 olguda Zone I, 18 olguda Zone II, 4 olguda Zone III, 1 olguda da Zone I+III yerleþimli idi. 21 olguya peroperatuvar hematom eksplorasyonu yapýldý. Etyolojide 5 olguda izole böbrek yaralanmasý olmasýna karþýn, 2 olguda izole pelvik fraktür, 1 olguda izole mesane yaralanmasý, 13 olguda ise birden fazla organ yaralanmasý saptandý. Biyolojiye yönelik tedavi yapýldý. Postoperatif morbidite %19 (5 olgu), mortalite %11 (3 olgu) idi. Bu çalýþma bize retroperitoneal hematomlarýn lokalizasyonuna göre tedavi stratejisinin önemini göstermiþtir.