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24.01.2018 | Original Article

Radiological classification of retroperitoneal hematoma resulting from lumbar vertebral fracture

Zeitschrift:
European Journal of Trauma and Emergency Surgery
Autoren:
Shota Nakao, Kazuo Ishikawa, Hidefumi Ono, Kenji Kusakabe, Ichiro Fujimura, Masato Ueno, Koji Idoguchi, Yasuaki Mizushima, Tetsuya Matsuoka
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00068-018-0907-x) contains supplementary material, which is available to authorized users.

Abstract

Purpose

Lumbar vertebral fracture (LVF) infrequently produces massive retroperitoneal hematoma (RPH). This study aimed to systematically review the clinical and radiographic characteristics of RPH resulting from LVF.

Methods

For 193 consecutive patients having LVF who underwent computed tomography (CT), demographic data, physiological conditions, and outcomes were reviewed from their medical records. Presence or absence of RPH, other bone fractures, or organ/vessel injury was evaluated in their CT images, and LVF or RPH, if present, was classified according to either the Orthopaedic Trauma Association classification or the concept of interfascial planes.

Results

RPH resulting only or dominantly from LVF was found in 66 (34.2%) patients, whereas among the others, 64 (33.2%) had no RPH, 38 (19.7%) had RPH from other injuries, and 25 (13.0%) had RPH partly attributable to LVF. The 66 RPHs resulting only or dominantly from LVF were radiologically classified into mild subtype of minor median (n = 35), moderate subtype of lateral (n = 11), and severe subtypes of central pushing-up (n = 13) and combined (n = 7). Of the 20 patients with severe subtypes, 18 (90.0%) were in hemorrhagic shock on admission, and 6 (30.0%) were clinically diagnosed as dying due to uncontrollable RPH resulting from vertebral body fractures despite no anticoagulant medication.

Conclusions

LVF can directly produce massive RPH leading to hemorrhagic death. A major survey of such pathology should be conducted to establish appropriate diagnosis and treatment.

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Zusatzmaterial
Supplementary material 1 (PDF 26 KB)
68_2018_907_MOESM1_ESM.pdf
Supplementary material 2 (PDF 202 KB)
68_2018_907_MOESM2_ESM.pdf
Supplementary material 3 (PDF 101 KB)
68_2018_907_MOESM3_ESM.pdf
Supplementary material 4 (PDF 13 KB)
68_2018_907_MOESM4_ESM.pdf
Supplementary material 5 (PDF 25 KB)
68_2018_907_MOESM5_ESM.pdf
Supplementary material 6 (PDF 39 KB)
68_2018_907_MOESM6_ESM.pdf
Supplementary material 7 (PDF 178 KB)
68_2018_907_MOESM7_ESM.pdf
Supplementary material 8 (PDF 343 KB)
68_2018_907_MOESM8_ESM.pdf
Supplementary material 9 (PDF 68 KB)
68_2018_907_MOESM9_ESM.pdf
Literatur
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