BILATERAL URETERAL OBSTRUCTION AND RENAL-FAILURE CAUSED BY MASSIVE RETROPERITONEAL HEMATOMA - IS THERE A PELVIC COMPARTMENT SYNDROME ANALOGOUS TO ABDOMINAL COMPARTMENT SYNDROME

Objectives: To describe an intrapelvic compartment syndrome analogous to abdominal compartment syndrome and to characterize its diagnosis an d treatment. Design: Retrospective analysis. Setting: Level I trauma c enter. Patients: Three patients with pelvic ring or acetabular fractur es presented with bilateral ureteral obstruction, renal organ failure, and anuria due to direct compression of both ureters in the true pelv is by a massive retroperitoneal hematoma. Intervention: Surgical thera py consisted of fracture stabilization, decompression of the retroperi toneal space, and evacuation of the hematoma. Persistent isolated blee ding points were either embolized preoperatively or ligated. Results: After decompression, all three patients promptly recovered their renal organ function. Conclusion: An intrapelvic compartment syndrome can b e defined as bilateral ureteral obstruction and renal failure caused b y a massive intrapelvic hematoma with increased retroperitoneal pressu re. Diagnostic differentiation of anuria in patients with pelvic ring or acetabular fractures must include intrapelvic compartment syndrome. Early diagnosis and treatment are mandatory.