What are the zones of retroperitoneum?

What are the zones of retroperitoneum?

To categorize the management of RPH, the retroperitoneum may be divided into three zones. Zone 1 (central) extends from the esophageal hiatus to the sacral promontory. Zone 2 (lateral) extends from the lateral diaphragm to the iliac crest. Zone 3 (pelvic) is confined to the retroperitoneal space of the pelvic bowl.

What are the retroperitoneal zones of injury?

The retroperitoneum is divided into three main zones of injury: zone I is the central/midline retroperitoneum, zone II encompasses the perinephric space, and zone III comprises the pelvic retroperitoneum. Treatment of retroperitoneal hematomas varies depending on the anatomical location and mechanism of injury.

What are the causes of hemoperitoneum?

What causes hemoperitoneum? Car accidents and sports injuries account for some cases of hemoperitoneum. Blunt trauma or injury to your spleen, liver, bowels, or pancreas can all injure your organs and cause this kind of internal bleeding. A common cause of hemoperitoneum is an ectopic pregnancy.

Is femoral artery retroperitoneal bleeding?

Retroperitoneal hemorrhage (RH) is a rare bleeding complication of percutaneous coronary intervention (PCI), which can result as a consequence of femoral access1 or can occur spontaneously,2,3 and has been shown to be independently associated with an increased risk of mortality and adverse events.

When do you explore retroperitoneal hematoma?

Mandatory exploration should be performed in cases of retroperitoneal hematomas resulting from penetrating injury, but the selection of treatment mode in blunt injury depends on the anatomical position of hematoma, visceral injury and the hemodynamic status of the patients.

What can cause a retroperitoneal hematoma?

Retroperitoneal hematoma can occur with trauma, surgical or other procedural manipulations, or spontaneously in patients who are on anticoagulation or antiplatelet therapy. They may also be a result of vascular retroperitoneal lesions such as cysts, aneurysms, tumors, or lipomas [3,4].

What is a Hemoperitoneum?

Hemoperitoneum, sometimes also called intra-abdominal hemorrhage or intraperitoneal hemorrhage, is a type of internal bleeding in which blood gathers in your peritoneal cavity.

Where is the hemoperitoneum?

Hemoperitoneum, sometimes also called intra-abdominal hemorrhage or intraperitoneal hemorrhage, is a type of internal bleeding in which blood gathers in your peritoneal cavity. This is the space between your organs and the inner lining of your abdominal wall.

Does hemoperitoneum cause peritonitis?

From this analysis, the majority of patients with significant isolated hemoperitoneum did not have clinical signs of peritonitis preoperatively. As only a small portion had peritoneal signs, it seems that isolated hemoperitoneum is not a plausible cause of peritonitis.

What type of arterial puncture is associated with an increased risk of retroperitoneal bleeding?

Patients with low body surface area also have a smaller femoral artery diameter, resulting in arterial access issues, and therefore an increased risk of RPH [6,14]. A higher femoral arterial puncture site is an important procedure-related risk factor for RPH [2,6,17].

What are the signs and symptoms of a Retroperitoneal bleed?

In terms of the diagnosis, the signs and symptoms of traumatic retroperitoneal hematoma include abdominal pain, abdominal distension, abdominal mass, severe back and lower quadrant pain and femoral neuropathy, all of which is nonspecific, leading to the difficulties in diagnosing traumatic retroperitoneal hematoma …

Is a retroperitoneal bleed a GI bleed?

Retroperitoneal bleeding is an accumulation of blood in the retroperitoneal space. Signs and symptoms may include abdominal or upper leg pain, hematuria, and shock. It can be caused by major trauma or by non-traumatic mechanisms….

What causes hemoperitoneum?

What is a hemoperitoneum?

How do I know if I have hemoperitoneum?

A paracentesis may be conducted to see what kind of fluid is building up in your abdominal cavity. This test is conducted using a long needle that draws fluid out of your abdomen. The fluid is then tested. A CT scan can also be used to detect hemoperitoneum.

How do you assess for retroperitoneal bleeding?

ASSESSMENT

1. loin and/ or abdominal pain.
2. often no cutaneous signs, but may have Cullen sign (umbilical ecchymosis) and Grey Turner sign (flank ecchymosis)
3. +/- palpable swelling.
4. haematuria.
5. haemodynamic instability and shock.
6. evidence of abdominal compartment syndrome (e.g. intra-abdominal hypertension, renal failure)

What is the Cattell Braasch maneuver?

A right medial visceral rotation, the Cattell-Braasch maneuver, is used to expose the entire inframesocolic retroperitoneal organs, including the inferior vena cava (IVC), the right renal pedicle, the right iliac vessels, the duodenum, and the head of the pancreas.

What is Kocherization of duodenum?

(kōk″ĕ-ri-zā′shŏn) [Emil Theodor Kocher] An operative maneuver to mobilize the duodenum before performing other procedures locally or before incising the duodenum, e.g., to expose the papilla of Vater.

What is the most common cause of retroperitoneal bleeding?

The most common cause of spontaneous retroperitoneal hemorrhage in most series are angiomyolipomas. Patients can present with a variety of symptoms including abdominal, hip, and upper thigh pain. Acute onset of flank pain is not uncommon.

How do you assess hemoperitoneum?

Is hemoperitoneum an ascites?

Conclusions: Hemoperitoneum is a severe complication in patients with ascites. When it develops spontaneously, it is usually related to the same disease process that caused the formation of ascites.

What are the different types of retroperitoneal hematoma?

The traumatic retroperitoneal hematoma heading can be further subdivided into penetrating versus blunt. The nontraumatic retroperitoneal hematoma category can be further broken down into spontaneous and iatrogenic. The diagnosis of retroperitoneal hematoma requires a high degree of clinical suspicion.

What are the anatomic regions of the retroperitoneum?

The retroperitoneum is divided into 3 anatomic regions that are utilized to guide therapy and describe the location of the retroperitoneal hematomas. Zone 1: The central retroperitoneum from the diaphragm superiorly to the bifurcation of the aorta inferiorly.

What is hemoperitoneum and how is it treated?

What Is Hemoperitoneum? Hemoperitoneum, sometimes also called intra-abdominal hemorrhage or intraperitoneal hemorrhage, is a type of internal bleeding in which blood gathers in your peritoneal cavity. This is the space between your organs and the inner lining of your abdominal wall.

How are retroperitoneal hematomas of the pelvis treated?

[15] Pelvic (Zone III) retroperitoneal hematomas are primarily the result of pelvic fractures and venous bleeding. These injuries are less amenable to surgical management. The initial approach to the patient with presumed blood loss due to pelvic injury is external pelvic fixation/binding, which may help to slow or tamponade the bleeding.