Henao and Aldrete classified retroperitoneal hematomas based on the anatomic location. The location may give an indication of the likely site of the bleeding giving rise to the hematoma. The authors are from the University of Alabama.


Hematoma = liquid and/or clotted blood

Category by Region

Anatomic Delimiters


within the pelvic space; not above the dome of the bladder anteriorly, the promontory posteriorly, and iliac crests laterally


lateral to the psoas muscle posteriorly and rectus sheath anteriorly, above the iliac crests and below the diaphragm


below the diaphragm, above the dome of the bladder anteriorly, above the promontory posteriorly; medial to psoas muscles


more than 1 anatomic region, may be massive


Pelvic hematomas may be associated with:

(1) pelvic fractures

(2) injuries to bladder and/or colon


Flank hematomas may arise from injury to:

(1) the kidneys (most often)

(2) colonic vessels

(3) small vessels to the lateral or posterior abdominal walls

Subcategories for central hematomas:

(1) associated with a major artery or vein: abdominal aorta, inferior vena cava, superior mesenteric artery, renal arteries, renal veins, common iliac arteries, common iliac veins, portal vein

(2) peri-pancreatic and/or periduodenal


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