Introducere: Hemoragiile retroperitoneale (HgRP) apar în politraumatism, însoţit cu lezări a structurilor abdominale şi retroperitoneale în 11-70% cazuri. Cel mai frecvent, în 21-100% cazuri hematom retroperitoneal (HRP) este diagnosticat în traumatismul pelvioabdominal, cu rata mortalitătii 78%. Timp îndelungat, HRP a fost considerat ca o complicaţie rară. Numărul de accidentaţi, la care este identiicat HgRP in iecare an creşte, ce se datorează capacităţii tehnice de diagnosticare cu precizie. Scopul: Analiza veridicităţii metodelor de diagnostic al hemoragiilor retroperitoneale. Material şi metode: Analizate rezultatele diagnosticului hemoragiilor retroperitoneale a 195 pacienţi cu traumatism pelvio-abdominal, complicat cu HgRP. Pacienţii au fost examinaţi după schema standartă. Suspectând formarea HRP, efectuat examen clinic, după indicaţii aplicate: USG, TC in dinamica; laparoscopia, laparotomia diagnostică. Valoarea diagnostică a metodelor de calcul a fost apreciată prin determinarea sensibilităţii, speciicităţii, preciziei (Bayes, Fisher). Rezultate: S-au constat simptome clinice nespeciice al HRP: dureri abdominale, lombare (n=120)- Se=89,55; Sp=28,2; Pr=75,72; escoriaţii(n=12), lezarea ţeseturilor regiunii lombare (n=10)- Se=100, Sp=100, Pr=100. S-au constatat semne clinice patognomonice a HRP: palparea formaţiunii de volum a regiunii lombare, abdominale (n=16). Pareza intesinală precoce (n=97). Simptomul Joyce– (n=9). Semnul Cullen’s- (n=3). Semnul Grey Turner’s (n=78). Hemoragia retroperitoneală сu metodele instrumentale a fost diagnosticată veritabil în examenul FAST la 81(41,53%) pacienţi -- sensibilitatea-69,44%, speciicitatea-100%, precizia-72,83%); TC- 36(18,46%) cazuri - sensibilitatea, speciicitatea, precizia-100%; Laparoscopia- 54(27,69%) cazuri - sensibilitatea-90,7%, speciicitatea-90,9%, precizia-90,74%; Laparotomia- 107(54,87%) cazuri- sensibilitatea-88,78%, speciicitatea-100%, precizia-87,75%. Concluzii: S-a constatat, că TC (Se=Sp=Pr=100%), laparoscopia (Pr=90,74%) şi laparotomia (Pr=92%) sunt cele mai informative metode de diagnostic al RPHg posttraumatice.

Introduction: Retroperitoneal haemorrhages (RPHg) occur in polytraumatism, accompanied by injuries of abdominal and retroperitoneal structures in 11-70% of cases. Most frequently, in 21-100% cases, retroperitoneal hematoma (RPH) is diagnosed in pelvic-abdominal trauma, with a mortality rate of 78%. For a long time, RPH has been considered as a rare complication. The number of injured persons with RPH is identiied each year increases, due to the technical diagnostic capability with precision. Aim: Analysis of the veracity of the methods of diagnosis of retroperitoneal haemorrhages. Material and methods: Analyzed the results of the retroperitoneal haemorrhage diagnosis of 195 patients with pelvic-abdominal trauma complicated by RPHg. Patients were examined after the standard scheme. In case of suspection of RPH, performed clinical examination and was applied: USG, TC, laparoscopy, laparotomy. The diagnostic value of method was determined throngh calculation of sensitivity, speciicity, accuracy (Bayes, Fisher). Results: There were non-speciic clinical symptoms of RPH: abdominal, lumbar pain (n=120)- Se=89,55; Sp=28.2, Pr=75,72; abortions (n=12), lumbar tissue damage (n=10)- Se=100, Sp=100, Pr=100. There were pathognomonic clinical signs of RPH: palpation of the lumbar, abdominal volume formation (n=16). Early intestinal paresis (n=97). The Joyce Symptom (n=9). The Cullen's sign (n=3). Gray Turner's sign (n=78). Retroperitoneal haemorrhage with instrumental methods was genuinely diagnosed in the FAST examination at 81(41,53%) patients- sensitivity-69.44%, speciicity-100%, accuracy-72,83%; CT- 36(18,46%) cases - sensitivity, speciicity, accuracy-100%; Laparoscopy- 54(27,69%) cases - sensitivity-90,7%, speciicity-90,9%, accuracy-90,74%; Laparotomy- 107(54,87%) cases - sensitivity-88,78%, speciicity-100%, accuracy-87,75%. Conclusions: TC(Se=Sp=Pr=100%), laparoscopy(Pr=90,74%) and laparotomy(Pr=92%) were found to be the most informative diagnostic methods for posttraumatic HgRP.