Retroperitoneal haematoma tracing: A comparative evaluation of accessible methods of study
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Hellenic Journal of Surgery (2014) 86:4, 248-253
Retroperitoneal Haematoma Tracing: A Comparative Evaluation of Accessible Methods of Study C. Simoglou, L. Simoglou, D. Gymnopoulos
Abstract Aim: This study attempted to evaluate two accessible methods of study, helical computerized tomography and
ultrasonography, in the acute and later context of an evolving retroperitoneal haematoma of traumatic origin in a clinical setting. Methods: The study involved a 21-year-old male patient who had suffered a stab wound. Exploratory laparotomy initially revealed a deep mid-abdominal stab wound. Owing to deep gastric penetration and profound hypovolemic shock, the wound had caused multiple visceral and vascular lacerations leading to peritonitis. This was largely due to the double wall penetrating lesion of the inferior vena cava, and also to the transection of superior mesenteric venous vessels, bleeding vascular branches within the lacerated head of the pancreas, greater omentum, mesentery and lacerated vascular structures of the abdominal rectus sheath. The patient was first managed operatively and thereafter clinically. Results: The patient was evaluated on postoperative (PO) days 5, 10 and 15 with ultrasonography and helical axial tomography. His clinical status was compared in relation to the evolving retroperitoneal haematoma on the same PO days. Conclusion: A close comparison of these three methods of evaluation seemed to correlate well with the evolution
of the haematoma, in terms of progression, infiltration, expansion and absorption. Accordingly, we found all three methods to be safe markers in the context of a closely monitored evolving retroperitoneal haematoma. Key words: Retroperitoneal haematoma, Evaluation of retroperitoneal haematoma, Methodology of retroperitoneal
haematoma study
Introduction This study aimed to report and evaluate upon the correlative findings of CT along with ultrasonographic and clinical evidence of the evolution of retroperitoneal haematoma, especially of its flow within the retroperitoneal space. Although bibliographic evidence is scarce on this subject, we have reviewed the existing literature and report our own experience upon this subject. Summarizing the above correlated features, we related our comparative findings to accessible methods of RH evaluation, such as H/CT, US and clinical examination. In the initial phase of an expanding RH, the infiltrative lesion can be directly monitored by both H/CT and US and indirectly so by clinical evaluation. These methods allow for C. Simoglou, L. Simoglou, D. Gymnopoulos General Hospital of Komotini, Surgical Clinic, Greece Corresponding Author: Dr. Christos Simoglou General Hospital of Komotini, Surgical Clinic, Greece Afroditis 11, T.K.69100, Komotini, Greece e-mail: [email protected] Received 05 April 2014; Accepted 23 April 2014 Hellenic Journal of Surgery 86
close monitoring of both the patient and his problem. As the RH ceased to expand, the patient’s clinical/laboratory status also improved. The literature is lacki
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