Trauma and burns: retroperitoneal haematoma at laparotomy: practice question

A General Surgery question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

Try it

General Surgery · Trauma and burns: retroperitoneal haematoma at laparotomy

Sample item

At laparotomy for blunt trauma, a stable patient is found to have a lateral perinephric retroperitoneal haematoma that is not expanding or pulsatile, and preoperative CT showed a grade II renal injury. What should the surgeon do with the haematoma?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Leave it undisturbed

A lateral (zone 2) retroperitoneal haematoma in blunt trauma is left alone if it is stable and non-expanding, as tamponade may be lost by exploration, increasing the need for nephrectomy. Central (zone 1) haematomas are explored, and a pelvic haematoma is left alone in blunt trauma.

Option by option

  • A. Pack the retroperitoneum widely and close

    Wide packing is for uncontrolled bleeding and is not required in a stable patient.

  • B. Open Gerota fascia and evacuate the haematoma

    Evacuation removes the tamponade and may convert a minor injury into a nephrectomy.

  • C. Explore the kidney through the haematoma to obtain vascular control

    Exploration without proximal vascular control risks uncontrolled haemorrhage and nephrectomy.

  • D. Leave it undisturbed (correct)

    Correct. A stable, non-expanding lateral haematoma in blunt trauma is best left undisturbed.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

More General Surgery questions

Questions about this General Surgery question

What is the answer to this General Surgery question?

The best answer is D, Leave it undisturbed. A lateral (zone 2) retroperitoneal haematoma in blunt trauma is left alone if it is stable and non-expanding, as tamponade may be lost by exploration, increasing the need for nephrectomy.

Why is "Pack the retroperitoneum widely and close" not the answer?

Wide packing is for uncontrolled bleeding and is not required in a stable patient.

Why is "Open Gerota fascia and evacuate the haematoma" not the answer?

Evacuation removes the tamponade and may convert a minor injury into a nephrectomy.

Why is "Explore the kidney through the haematoma to obtain vascular control" not the answer?

Exploration without proximal vascular control risks uncontrolled haemorrhage and nephrectomy.

What concept does this question test?

It tests Trauma and burns: retroperitoneal haematoma at laparotomy in General Surgery. Central (zone 1) haematomas are explored, and a pelvic haematoma is left alone in blunt trauma.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Trauma and burns: retroperitoneal haematoma at laparotomy?

Learn classic signs and eponyms alongside what they diagnose. Then use the flashcards and the other General Surgery questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.