[Spontaneous evacuation of a traumatic retroperitoneal hematoma through the colon]

Retroperitneal hemorrhage following blunt trauma of the abdomen is an ever more frequent problem confronting the surgeon in everyday practice. This paper presents an interesting and exceptionally rare case concerning a patient with a blunt injury of the abdomen which resulted in the rupture of the retroperitoneal portion of the colon between the descendens and sigmoid. A resultant retroperitoneal hematoma was palpable as an elastic mass. Contamination with bacteria lead to infection of the hematoma with the subsequent formation of an abscess. Later this abscess spontaneously evacuated itself through the rupture in the colon which was verified with irigography. As a late consequence of this abscess drainage, the colon became constricted. This process as of yet has not caused any difficulties in passage but nonthe-less surgery was indicated which the patient refused. The authors believe that the retroperitoneal hematoma caused by blunt injury of the abdomen is one of the most difficult diagnostic problems because this anatomical region is inaccessible and lesions within its confines are difficult to detect.