Unfavorable iliac artery anatomy causing access limitations during endovascular abdominal aortic aneurysm repair: application of the endoconduit technique

The Frequency of Parenchimatous Lesions in Patients with Traumatic Retroperitoneal Hematoma

Objective: The retroperitoneum represent the anatomical region with the highest mortality rates, in which lesions in this region need special relevance. The aim of this study is to find out the frequency of different parenchimatous injuries related to different zones.

Methods: In this retrospective study, all cases who presented to the emergency room and/or admitted to our center with retroperitoneal hematoma (RPH) complicated with parenchimatous lesions from January 2016 to December 2019 were included (4-years data). Data collected included age, hematoma zones, the production mechanisms, mortality, surgical interventions, parenchymatous lesions, complications and biochemical and hematological analysis (e.g. hemoglobin (Hb), hematocrit (Ht), platelets (PLT), leukocytes (Leu), aspartate aminotransferase level (AST), alanine aminotransferase level (ALT) and creatinine (Cr). All RPHs were diagnosed using computed tomography scan.

Results: A total number of 119 RPH cases with parenchimatous lesions were included with a mean age of 45.56±2.52. The most common type of RPH was located in lateral zone (zone II) with 65 cases, followed by pelvic zone (zone III) with 36 cases. The main production mechanism for parenchimatous lesions was by road accident (n=57). The highest prevalence of parenchimatous lesions was seen in both lung and splenic lesions (n=54), followed by liver lesion (n=36) and kidney lesions (n=11), without any statistical significance. The complications showed a statistical significance when 2016 year was compare with 2018 (p=0.013). Regarding the biochemical and hematological analysis, a statistical significance was seen at PLT (when 2016 was compared with 2017, p=0.03 and 2018, p=0.008). Only 67 patients were treated by surgical interventions, and the highest mortality was registered in 2019 (n=11).

Conclusion: There is a lack of evidence in the frequency of different parenchimatous lesions in RPH cases. We conclude on the basis of our study that mandatory exploration of zone II and III haematoma in parenchimatous lesions should be early diagnosed in order to reduce the morbidity and mortality of the patients.