Retroperitoneal injuries: Pitfalls in diagnosis and management

Kimball I. Maull, Grace Rozycki, G. O’Neal Vinsant, Randall E. Pedigo

Research output: Contribution to journalArticle

Abstract

Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. To determine the effect, if any, of CT examination on the diagnosis and management of retroperitoneal trauma, we reviewed our patient experience. During the 16-month period ending in April 1986, 135 patients sustained 177 retroperitoneal injuries (116 by blunt and 19 by penetrating trauma). There were 26 deaths (19% mortality). There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management.

Original languageEnglish (US)
Pages (from-to)1111-1115
Number of pages5
JournalSouthern medical journal
Volume80
Issue number9
DOIs
StatePublished - Jan 1 1987
Externally publishedYes

Fingerprint

Wounds and Injuries
Nonpenetrating Wounds
Vascular System Injuries
Hematuria
Craniocerebral Trauma
Hematoma
Shock
Spine
Ethanol
Tomography
Observation
Hemorrhage
Mortality
Incidence

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Retroperitoneal injuries : Pitfalls in diagnosis and management. / Maull, Kimball I.; Rozycki, Grace; O’Neal Vinsant, G.; Pedigo, Randall E.

In: Southern medical journal, Vol. 80, No. 9, 01.01.1987, p. 1111-1115.

Research output: Contribution to journalArticle

Maull, Kimball I. ; Rozycki, Grace ; O’Neal Vinsant, G. ; Pedigo, Randall E. / Retroperitoneal injuries : Pitfalls in diagnosis and management. In: Southern medical journal. 1987 ; Vol. 80, No. 9. pp. 1111-1115.
@article{3af185fa3f27471c8cab02fdd3ae5074,
title = "Retroperitoneal injuries: Pitfalls in diagnosis and management",
abstract = "Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. To determine the effect, if any, of CT examination on the diagnosis and management of retroperitoneal trauma, we reviewed our patient experience. During the 16-month period ending in April 1986, 135 patients sustained 177 retroperitoneal injuries (116 by blunt and 19 by penetrating trauma). There were 26 deaths (19{\%} mortality). There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management.",
author = "Maull, {Kimball I.} and Grace Rozycki and {O’Neal Vinsant}, G. and Pedigo, {Randall E.}",
year = "1987",
month = "1",
day = "1",
doi = "10.1097/00007611-198708090-00010",
language = "English (US)",
volume = "80",
pages = "1111--1115",
journal = "Southern Medical Journal",
issn = "0038-4348",
publisher = "Lippincott Williams and Wilkins",
number = "9",

}

TY - JOUR

T1 - Retroperitoneal injuries

T2 - Pitfalls in diagnosis and management

AU - Maull, Kimball I.

AU - Rozycki, Grace

AU - O’Neal Vinsant, G.

AU - Pedigo, Randall E.

PY - 1987/1/1

Y1 - 1987/1/1

N2 - Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. To determine the effect, if any, of CT examination on the diagnosis and management of retroperitoneal trauma, we reviewed our patient experience. During the 16-month period ending in April 1986, 135 patients sustained 177 retroperitoneal injuries (116 by blunt and 19 by penetrating trauma). There were 26 deaths (19% mortality). There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management.

AB - Retroperitoneal injury caused by penetrating trauma or associated with progressive shock following blunt trauma is usually recognized promptly and managed appropriately. Isolated retroperitoneal injury from blunt trauma, unless accompanied by major hemorrhage or gross hematuria, is often difficult to diagnose and needed treatment may be delayed. Although clinical examination remains the cornerstone of diagnosis, the high incidence of ethanol abuse and/or concurrent head injury in trauma patients has led to increased use of computed tomography in the diagnosis of abdominal trauma. To determine the effect, if any, of CT examination on the diagnosis and management of retroperitoneal trauma, we reviewed our patient experience. During the 16-month period ending in April 1986, 135 patients sustained 177 retroperitoneal injuries (116 by blunt and 19 by penetrating trauma). There were 26 deaths (19% mortality). There were 90 pelvic fractures and 31 lumbar spine fractures, as well as 21 genitourinary, 12 gastrointestinal, five pancreatic, and eight major vascular injuries. Ten patients had isolated retroperitoneal hematomas. We conclude that (1) patients with retroperitoneal injuries and coexisting intraperitoneal injuries should have early operation; (2) isolated retroperitoneal trauma tends to lead to observation unless CT is used as part of the early assessment; and (3) routine use of CT in patients at risk accurately defines the extent of injury and enhances clinical management.

UR - http://www.scopus.com/inward/record.url?scp=0023247440&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0023247440&partnerID=8YFLogxK

U2 - 10.1097/00007611-198708090-00010

DO - 10.1097/00007611-198708090-00010

M3 - Article

C2 - 3629315

AN - SCOPUS:0023247440

VL - 80

SP - 1111

EP - 1115

JO - Southern Medical Journal

JF - Southern Medical Journal

SN - 0038-4348

IS - 9

ER -