OTA-AAST Pelvic Injury Symposium: Abstracts


TITLE: Bilateral ureteral obstruction and renal failure caused by massive retroperitoneal hematoma: is there a pelvic compartment syndrome analogous to abdominal compartment syndrome? AUTHORS: Hessmann M; Rommens P AUTHOR AFFILIATION: Department of Traumatology, University Hospitals of the Johannes-Gutenberg University, Mainz, Germany. SOURCE: J Orthop Trauma 1998 Nov-Dec;12(8):553-7 CITATION IDS: PMID: 9840788 UI: 99054523 ABSTRACT: OBJECTIVES: To describe an intrapelvic compartment syndrome analogous to abdominal compartment syndrome and to characterize its diagnosis and treatment. DESIGN: Retrospective analysis. SETTING: Level I trauma center. PATIENTS: Three patients with pelvic ring or acetabular fractures presented with bilateral ureteral obstruction, renal organ failure, and anuria due to direct compression of both ureters in the true pelvis by a massive retroperitoneal hematoma. INTERVENTION: Surgical therapy consisted of fracture stabilization, decompression of the retroperitoneal space, and evacuation of the hematoma. Persistent isolated bleeding points were either embolized preoperatively or ligated. RESULTS: After decompression, all three patients promptly recovered their renal organ function. CONCLUSION: An intrapelvic compartment syndrome can be defined as bilateral ureteral obstruction and renal failure caused by a massive intrapelvic hematoma with increased retroperitoneal pressure. Diagnostic differentiation of anuria in patients with pelvic ring or acetabular fractures must include intrapelvic compartment syndrome. Early diagnosis and treatment are mandatory. MAIN MESH HEADINGS: Acetabulum/*injuries
Compartment Syndromes/*etiology
Fractures/*complications
Hematoma/*complications
Kidney Failure, Acute/*etiology
Pelvic Bones/*injuries
Ureteral Obstruction/*etiology ADDITIONAL MESH HEADINGS: Acetabulum/radiography
Adult
Case Report
Female
Fractures/radiography
Human
Male
Middle Age
Pelvic Bones/radiography
Retroperitoneal Space
1998/12
1998/05 03:45 PUBLICATION TYPES: JOURNAL ARTICLE LANGUAGES: Eng