Traumatic multiorgan entrapment syndrome: retroperitoneal transdiaphragmatic herniation and pelvic-thoracic compartment syndrome: a systematic review
DOI:
https://doi.org/10.70577/xnxv0h42Keywords:
multiorgan entrapment syndrome, transdiaphragmatic herniation, compartment syndrome, blunt trauma, retroperitoneum, diaphragmatic injury, pelvic-thoracic compartment syndromeAbstract
Introduction: Traumatic multiorgan entrapment syndrome (TMES) is an exceptional clinical entity characterized by transdiaphragmatic herniation of retroperitoneal structures and the development of pelvic-thoracic compartment syndrome following severe blunt trauma. This condition, first described in the trauma literature as a rare but devastating complication, combines diaphragmatic injury with entrapment of retroperitoneal organs and consequent elevation of intracompartmental pressure (Brasel et al., 2020; Johnson & Brasel, 2023). Objective: To synthesize the available evidence on the clinical presentation, diagnosis and management of traumatic multiorgan entrapment syndrome with retroperitoneal transdiaphragmatic herniation and pelvic-thoracic compartment syndrome. Methodology: Systematic review following PRISMA 2020 guidelines (Page et al., 2021). A systematic search was conducted in PubMed, LILACS, SciELO and Cochrane for studies published between 2000 and 2025 reporting cases of traumatic retroperitoneal transdiaphragmatic herniation with compartmental compromise. Case reports, case series and observational studies were included. Methodological quality was assessed using the adapted Newcastle-Ottawa scale (Wells et al., 2000). Results: Nine studies (n=14 patients) were included. The most frequent trauma mechanism was high-energy motor vehicle accident (78.6%, n=11). Retroperitoneal herniation occurred in all cases, with renal involvement in 78.6% (n=11), colonic involvement in 42.9% (n=6) and pancreatic involvement in 28.6% (n=4). Pelvic-thoracic compartment syndrome was documented in 71.4% (n=10) of cases. Overall mortality was 28.6% (n=4). Conclusion: TMES is an exceptional but potentially lethal entity that requires a high index of suspicion in patients with severe blunt trauma. Early identification through imaging studies and multidisciplinary surgical management are essential to reduce associated morbidity and mortality.
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Copyright (c) 2026 Carlos Jonnathan Cuzco Guillermo, Adriana Cristina Cabascango Soria, Mónica Sofía Ramos Vargas, Francisco Javier Ramírez Rengifo, Sebastián Octavio Cárdenas Cruz (Autor/a)
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