Pelvic compartment syndrome caused by retroperitoneal hematoma of pelvic fracture

摘要

Retroperitoneal hematoma is an obligatory complication in pelvic ring fracture. In most cases, the bleeding originates from venous vessels of the presacral plexus, small arteries and veins from fracture fragments. External fixation of the pelvis can control blood loss by reducing diastasis and dramatically decreasing the volume of the pelvis. But this tamponade effect can not prevent the presence of hematoma in the adjoining retroperitoneal space. It is well known that complication of retroperitoneal hematoma is infection and sepsis. Another dramatic complication of retroperitoneal hematoma is obstruction of the ureter with renal failure. This problem is rarely mentioned in literature. In 1982, Antoci et al reported a case of pelvic fracture complicated by ureteral obstruction. The concept of pelvic compartment syndrome was mentioned by Hessmann et al in 1998. In 2003, a case of pelvic compartment syndrome was treated by the authors of this study.