Junaid Sultan, Haris Bin Bilal, Humaira Kiran, Badar Bin Bilal, Azam Yusuf.
Management of retro peritoneal hematoma.
Professional Med J Jan ;12(3):230-6.

To find out the frequency of different visceral injuries and morbidity and mortality related to different zones in retro peritoneal haematoma due to trauma. Place of study: D.H.Q Teaching Hospital Rawalpindi. Study Design: Prospective study. Duration of study: June 1998 to May 1999. Results: There were total 45 patients with retro peritoneal haematoma. The policy for exploration of retroperitoneal hematoma included mandatory exploration of Zone I and selective exploration of Zone II and III. Out of total 45 patients, 40 had associated intra peritoneal injuries and Zone I was most commonly involved (n=21) followed by Zone II (n=13) & Zone III (n=11). Vascular, genitourinary and pelvic fracture injuries were the common injuries. Overall mortality was 6.5% mainly due to irreversible shock in patients with Zone I vascular injuries. Conclusion: Mandatory exploration of Zone I and selective exploration of Zone II & III is a valid policy in the management of retro peritoneal haematomas. Penetrating Zone I trauma causing vascular injuries is most common of all. Shock is the most common presentation, complication and cause of mortality.

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