Delayed hydronephrosis due to retroperitoneal hematoma after a seatbelt injury: A case report

RATIONALE

Hydronephrosis caused by retroperitoneal hematoma after a seatbelt injury is a unique clinical entity.

PATIENT CONCERNS

A 21-year-old man, who had been wearing a seatbelt, was brought to our hospital after a motor vehicle collision, complaining of abdominal pain. Computed tomography (CT) revealed retroperitoneal hematoma in the upper pelvic region. Since he was hemodynamically stable throughout admission, he was managed conservatively. Seventeen days after initial discharge, the patient revisited our emergency department due to right back pain.

DIAGNOSES

CT scans indicated retroperitoneal hematoma growth resulting in hydronephrosis of the right kidney.

INTERVENTIONS

Laparoscopic drainage of the retroperitoneal hematoma was successfully performed.

OUTCOMES

His symptoms resolved after the surgery. Follow-up CT scans three months later demonstrated complete resolution of the hydronephrosis and retroperitoneal hematoma.

LESSONS

Our case highlights a patient with delayed hydronephrosis because of retroperitoneal hematoma expansion after a seatbelt injury.

The unusual chance fracture: case report & literature review

The Chance fracture represents a spinal lesion caused by a flexion-distraction injury pattern. We describe a rare case of a male driver admitted at the Emergencies of our Institution, level A Trauma center. The was involved in an automobile accident without wearing a seatbelt. Radiological findings of plain radiography and computed tomography (CT) demonstrated a horizontal fracture extending across the vertebral body to the posterior elements with loss of vertebral height at the anterior aspect of T12. Based on these findings, the diagnosis of a T12 Chance fracture was established. The patient was treated conservatively with a thoracolumbar orthosis, without any subsequent disabilities. Although Chance fractures are rare lesions, they should always be considered in spinal injuries, even in cases of motor-vehicle accidents where no seatbelt is used.