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 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.
Observation
Exploratory laparotomy through a midline incision
CT scan-guided aspiration
Surgical exploration through a left-flank retroperitoneal approach
Trauma