Retroperitoneal Injury

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Presentation transcript:

Retroperitoneal Injury

Retroperitoneal Injury Outline General approach. Anatomical boundaries. Retroperitoneal Zones. Cases. Surgical Exposure.

Retroperitoneal Injury Approach. Mechanism of injury. Blunt abdominal injury. Mostly non-operative management. Penetrating abdominal injury. Mostly requires exploration.

Retroperitoneal Injury Anatomical boundaries. The Anterior Abdomen. The Flank. The Thoracoabdominal area. The Box.

Retroperitoneal Injury Anatomical boundaries.

Zone 1

Zone 2

Zone 3

Retroperitoneal Injury

Retroperitoneal Injury Case 1: 29 year old male, High speed MVC. Ejected from the car. Unconscious, Sat 88, BP:90/50, GCS 6, no external source of bleeding. Intubated, bilateral chest tubes inserted, pelvis wrapped. Sat 94, HR:110, BP:90/50. FAST positive.

Retroperitoneal Injury Case 1: Trauma laparotomy. Splenectomy. Zone 1 hematoma. Zone 2 hematoma. Zone 3 hematoma.

Retroperitoneal Injury Case 2: 42 year old male, abdominal stab. Alert, Sat:99, BP:145/65, HR:89. Has a 2 cm wound in the anterior abdominal wall.

Retroperitoneal Injury Case 2: Trauma laparotomy. Small bowel injury. Zone 1 hematoma. Stable. Unstable.

Retroperitoneal Injury Case 2: Trauma laparotomy. Small bowel injury. Zone 2 hematoma. Stable. Unstable.

Retroperitoneal Injury Case 2: Trauma laparotomy. Small bowel injury. Zone 3 hematoma. Stable. Unstable.

Retroperitoneal Injury Left medial visceral rotation.

Retroperitoneal Injury Mattox maneuver

Retroperitoneal Injury Right medial visceral rotation.

Retroperitoneal Injury Cattell-Braasch manoeuvre

Discussion & Questions