Hematoma retroperitoneal posterior a histerectomía vaginal con colporrafia anterior y posterior en Bogotá (Colombia): reporte de un caso y revisión de la literatura

摘要

Objective: To report the case of a patient who developed a retroperitoneal haematoma following prolapse correction surgery through the vaginal approach; and to review the medical literature relating to the anatomy of the retroperitoneal space and the aetiology, diagnosis, management and prognosis of postoperative retroperitoneal haematoma in gynaecology. Materials and methods: Case presentation of a patient with Stage II vaginal prolapse, who was undergone for vaginal hysterectomy with anterior and posterior vaginal wall repair. She had a retroperitoneal haematoma complication. The patien underwent surgery at Samaritana University Hospital, a level III public hospital and referral centre for the Cundinamarca region, located in Bogotá (Colombia). A search in the literature was conducted in the Medline database through PubMed, Jstor and Lilacs using the MeSH terms "vaginal hysterectomy" and "retroperitoneal haematoma". The search was limited to publications in English and Spanish between 1980 and 2015. Results: Overall, 15 articles were found, 3 of which describe cases secondary to gynaecological procedures. The final review consisted of 4 topic reviews, 8 case reports 2 case series and 1 observational descriptive study. Conclusion: Retroperitoneal haematoma is a rare clinical finding and diagnosis requires a high level of clinical suspicion. Several diagnostic tools are available, computed tomography being the most useful. Management has to be individualized in each case. If the patient is stable, the treatments of choice include conservative management, which can be successful, or endovascular interventions. However, in haemodynamically unstable patients, laparotomy is the most recommended treatment approach.