Introducere: Hemoragiile retroperitoneale (HRP) ocupă un loc important în chirurgia de urgență, rămânând o problemă greu de explorat, având o
influență nefavorabilă asupra tratamentului pacienților cu traumatism asociat. Scopul: Evaluarea comparativă a datelor clinice şi morfopatologice a HRP
în traumatismul asociat. Material si metode: Studiul include prelucrarea datelor a 63 victime cu traumatism asociat, complicat cu HRP, bazat pe analiza
comparativă a datelor expertizei medico-legale şi clinice. Cauzele traumei: accidente rutiere-44(69,84%), catatrauma-15(23,8%), strivire-4(6,34%) cazuri.
Metode: examen clinic, radiologic, USG, TC, laparoscopia, laparotomia, metode complexe morfopatologice. Rezultate: Examinările lotului de studiu:
USG-14(22,22%); examenul radiologic-63(100%), TC-3(4,76%) cazuri. S-a efectuat: laparoscopia-13(20,63%), laparotomia de urgență-50(79,36%)
cazuri. La toți pacienți s-a depistat fracturi ale bazinului, lezarea organelor interne: ficat-18, splină-21, rinichi-6, vezica urinară-12, intestin-11 cazuri,
etc. HRP s-a depistat la 51 accidentați, în următoarele zone de răspândire a HRP: zona I-1, II-6, III-15, mixtă-29 cazuri. Necătând la tratamentul
efectuat, din cauzele multiple şi severitatea traumatismului (media ISS=47,28±17,68), pacienții au decedat. Cauzele decesului: şoc ireversibil(24),
insuficiența poliorganică (27), insuficiența cardio-vasculară(6), complicații septice(3), traumatism cranio-cerebral grav(3). Examenul medico-legal a
completat şirul de leziuni ale organelor interne, inclusiv la 12 decedați, numai la autopsie, a fost depistată HRP şi zonele ei de răspândire: la 9-în zona
III, la 3-zona mixtă. Concluzie: Semnificația medico-legală este indiscutabilă în aprecierea precisă a leziunilor organelor interne şi răspândirea zonală
a HRP. Studiul comparativ a datelor clinice şi expertizei medico-legale a demonstrat, că zonele de răspândire a HRP depistate în clinică, în majoritate
coincid cu datele expertizei medico-legale.
Introduction: The retroperitoneal hemorrhages (HRP) occupies an important place in emergency surgery, remaining a difficult issue to explore, having
a negative influence on the patients treatment in associated trauma, complicated with HRP. Aim: The comparative evaluation of clinical and pathological
data of HRP in the associated trauma. Material and methods: The study includes the processing data of 63 victims with associated trauma, complicated
with the retroperitoneal hemorrhage, based on the comparative analysis of forensic and clinical data. The causes of trauma: car accident-44(69,84%),
katatrauma-15(23,8%), compression-4(6,34%) cases. Methods: general clinical examination, USG, X-ray, TC, laparoscopy data, laparotomy, forensic
results with the complex morph-pathological methods. Results: The study group were examined: USG-14(22,22%), X-ray-63(100%), TC-3(4,76%)
cases. It was made: laparoscopy-13(20,63%), emergency laparotomy-50(79,36%) cases. All patients were diagnosed with pelvic fractures; damage of
the internal organs: liver-18, spleen-21, kidney-6, urinary bladder-12, bowel-11 cases, etc. HRP was detected in 51 cases, in the following areas of
the spread of the HRP: zone I-1, II-6, III-15, combined-29 cases. Regarding to the treatment made, due to multiple causes and the severity of trauma
(mean ISS=47,28±17,68) patients died. The death causes: irreversible shock(24), MODS(27), cardiovascular shortage(6), septic complications(3), severe
skull-cerebral trauma(3). Forensic examination completed the row of injuries of the internal organs, including 12 deaths, only at the autopsy, HRP and
the zones of the spread were traced out: in 9cases-in zone III, 3–mixed zones. Conclusion: Forensic significance is indisputable accurate in assessing
damage internal organs and zonal spread of HRP. The compared study of clinic and forensic expertise data demonstrated that spreading zones of HRP
detected in hospital, mostly coincide with forensic expertise data.
