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Overview of the diagnosis and initial management of traumatic retroperitoneal injury

Samuel P Mandell, MD, MPH, FACS
Section Editor
Eileen M Bulger, MD, FACS
Deputy Editor
Kathryn A Collins, MD, PhD, FACS


Traumatic injury to retroperitoneal structures often accompanies abdominal trauma. The retroperitoneum represents a potential anatomic space that is immediately posterior to the abdominal cavity. It contains organs that are entirely within the retroperitoneum, as well as some organs that traverse from and back into the abdominal cavity. Hemodynamically unstable patients with retroperitoneal hematoma represent an intraoperative diagnostic challenge. A high clinical suspicion is needed to recognize and appropriately manage retroperitoneal injuries.

An overview of the injury mechanisms, recognition, and management of traumatic injury to the retroperitoneum is provided. The initial evaluations of blunt and penetrating injury to the abdomen are reviewed separately.

(See "Initial evaluation and management of blunt abdominal trauma in adults".)

(See "Initial evaluation and management of abdominal stab wounds in adults".)


Operative management and the decision for retroperitoneal exploration require a thorough knowledge of the mechanism of injury and of the organs contained within and adjacent to each other in the retroperitoneum (figure 1).

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Literature review current through: Nov 2017. | This topic last updated: Dec 19, 2016.
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