Penetrating lateral retroperitoneal haematoma - do you go in??

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All penetrating retroperitneal haemotomas = EXPLORATION

Only exception maybe a perinephric haematoma with preoperative imaging,
preferably a CT to Grade the injury - even then you MUST reflect the colon.

We donot do CT for patients with who alreayu have an indication for a
laparotomy - therefore we EXPLORE ALL.

PHN
Busy urban trauma center in South Africa

Karim Brohi wrote:

> A quick poll to the group:
>
> Penetrating injury to the abdomen, you're doing a lapararotomy for whatever
> reason.  When you get in there's a large lateral retroperitoneal haematoma.
> The patient is h(a)emodynamically normal. The haematoma is big but not
> pulsatile, not expanding.
>
> You'd leave it if it was blunt trauma.  Standard practice for penetrating
> would say explore.
>
> Would YOU go in?
>
> Karim
>
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