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Wednesday, June 2, 2021

Retroperitoneal Trauma

EmDocs - June 01, 2021 - By Aaron Lacy and Clifford L. Freeman
Reviewed by: Alexander Y. Sheng; Alex Koyfman; Brit Long
Pearls
  • Trauma patients with hemodynamic changes with a negative chest x-ray, E-FAST, and pelvic x-ray should be presumed to have retroperitoneal trauma until proven otherwise.
  • The most common cause of retroperitoneal trauma is secondary to zone 3 injuries in the pelvis. Use pelvic binders to stabilize pelvic ring fractures at the bedside, and rapid transition to extra-peritoneal packing to reduce further hemorrhage.
  • Once the patient is stable enough for CT, obtaining CT with IV contrast is critical to diagnosing and evaluating the source of retroperitoneal hemorrhage.
  • Patients with hemodynamic instability and retroperitoneal hemorrhage require either interventional radiology or surgical specialist intervention for definitive care.
  • Any type of retroperitoneal hemorrhage requires multidisciplinary care, no matter the patient’s hemodynamic instability