6533b86cfe1ef96bd12c8341

RESEARCH PRODUCT

Bilateral ureteral obstruction and renal failure caused by massive retroperitoneal hematoma: is there a pelvic compartment syndrome analogous to abdominal compartment syndrome?

subject

description

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.