retroperitoneal hematoma

Retroperitoneal hematoma refers to the accumulation of blood in the retroperitoneal space forming a hematoma after retroperitoneal organs and blood vessels are injured and bleed due to external forces. Retroperitoneal hematoma is a common complication of abdominal and lumbar injuries, accounting for approximately 10–40%, and can be caused by direct or indirect violence. The most common cause is pelvic and spinal fractures, accounting for about two-thirds of cases. The next most common causes are rupture of retroperitoneal organs (kidney, bladder, duodenum, and pancreas, etc.) and injury to major blood vessels and soft tissues. Because it is often combined with severe multiple injuries and hemorrhagic shock, the mortality rate can reach 35–42%. When the hematoma extends into the pelvic cavity, there may be a feeling of tenesmus, and a fluctuant bulge in the presacral area can be palpated on digital rectal examination. B-mode ultrasound or CT examination can aid in diagnosis. If the posterior peritoneum is ruptured and blood flows into the peritoneal cavity, abdominal paracentesis has some diagnostic value.