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Surgery Trauma 12479c21

A 70-year-old man is brought to the emergency department following a car crash. X-rays revealed a fractured rib on the left and a fracture of the right femur. A CT scan of the abdomen showed a left-sided retroperitoneal hematoma adjacent to the left kidney and no evidence of urine extravasation. The hematoma should be managed by which of the following?

A
Observation
B
Exploratory laparotomy through a midline incision
C
CT scan-guided aspiration
D
Surgical exploration through a left-flank retroperitoneal approach
High-Yield Explanation
A small nonexpanding hematoma with no associated urine extravasation can be managed by observation with repeat CT scan or ultrasound. If the patient becomes hypotensive, exploration through a midline incision would be indicated.

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