Retroperitoneal hemorrhage (bleeding edge)

Pelvis | Urology | Retroperitoneal hemorrhage (bleeding edge) (Disease)


Retroperitoneal hemorrhage (or retroperitoneal hematoma) refers to an accumulation of blood found in the retroperitoneal space.

Causes and Risk factors

A retroperitoneal hematoma is most commonly caused by a traumatic impact to the body or an injury caused by an object penetrating the abdominal or pelvic cavities. The internal bleeding that occurs with these types of injuries collects to form a hematoma.

The great vessels of the vena cava and the aorta, as well as the vessels that support the retroperitoneal organs, can be injured to cause the initial bleeding. Wunderlich syndrome is also known as spontaneous retroperitoneal hemorrhage (SRH). SRH is commonly associated with Lenk’s triad (acute flank pain,symptoms of internal bleeding, and upper and lower quadrant abdominal tenderness to palpation – costovertebral angle tenderness).

Diagnosis and Treatment

In patients with acute abdominal pain, the evaluation of intraabdominal pathology based on clinical symptoms and signs might be often unreliable. Laparoscopy, as a minimally invasive technique, has unique advantages in such cases and should be regarded as a good diagnostic tool.

Treatment of spontaneous retroperitoneal bleeding, as withother bleeding phenomena, revolves around resuscitationand restoration of circulating volume - packed red blood cells (PRBCs), fresh frozen plasma, units of platelets, colloids. This has traditionally been followed by surgical correction in hemodynamically unstable patients. Radiological intervention with embolization of the feeding vessel is an option in splanchnicaneurysms.


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