Non-operative management of stable, non-pulsatile, retroperitoneal hematomas in blunt abdominal trauma

A 33 year-old male sustained blunt abdominal trauma requiring emergent exploration which revealed a grade IV liver injury with a right zone II retroperitoneal and supramesocolic hematoma, and a zone I central retroperitoneal hematoma, all of which were nonexpanding and nonpulsatile, and therefore were left undisturbed.

Multiple techniques have been used for management of retroperitoneal hematomas such as manual tamponade with clamping and balloon occlusion catheters, tight sponge packing followed by temporary closure, percutaneous balloon catheter occlusion, and endovascular repair.

Stable, non-pulsatile, nonexpanding, retroperitoneal hematomas can be observed, even in the face of other injuries.