Spontaneous retroperitoneal hematoma: a case report
Takuma KurotakiNaoya OkadaYasuo SakuraiTakumi YamabukiMinoru TakadaKentaro KatoTakeshi YokoyamaYoshiyasu AmboYoshihiro KinoshitaFumitaka NakamuraNobuichi Kashimura
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Abstract Background Spontaneous retroperitoneal hematoma is defined as bleeding in the retroperitoneal space without any triggers such as trauma, invasive procedures, and abdominal aortic aneurysm. Case presentation A 48-year-old Japanese man who experienced sudden abdominal pain, severe hypotension, and decreased hemoglobin was diagnosed with spontaneous retroperitoneal hematoma. Contrast-enhanced computed tomography revealed massive left retroperitoneal hematoma; however, neither extravasation nor causative aneurysm was noted. Through conservative management with close monitoring, he was treated and discharged on the tenth hospital day without any morbidity. Conclusions Spontaneous retroperitoneal hematoma treatment comprises conservative management, transcatheter arterial embolization, and surgical intervention. The mortality rate of spontaneous retroperitoneal hematoma is so high that the optimal treatment timing needs to be carefully judged on the basis of detailed evaluation, and management algorithm with clear criteria.Keywords:
Retroperitoneal Hemorrhage
Retroperitoneal space
Extravasation
Arterial Embolization
Presentation (obstetrics)
Surgical oncology
Conservative Management
Abstract Background Spontaneous retroperitoneal hematoma is defined as bleeding in the retroperitoneal space without any triggers such as trauma, invasive procedures, and abdominal aortic aneurysm. Case presentation A 48-year-old Japanese man who experienced sudden abdominal pain, severe hypotension, and decreased hemoglobin was diagnosed with spontaneous retroperitoneal hematoma. Contrast-enhanced computed tomography revealed massive left retroperitoneal hematoma; however, neither extravasation nor causative aneurysm was noted. Through conservative management with close monitoring, he was treated and discharged on the tenth hospital day without any morbidity. Conclusions Spontaneous retroperitoneal hematoma treatment comprises conservative management, transcatheter arterial embolization, and surgical intervention. The mortality rate of spontaneous retroperitoneal hematoma is so high that the optimal treatment timing needs to be carefully judged on the basis of detailed evaluation, and management algorithm with clear criteria.
Retroperitoneal Hemorrhage
Retroperitoneal space
Extravasation
Arterial Embolization
Presentation (obstetrics)
Surgical oncology
Conservative Management
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Spontaneous retroperitoneal hematoma (SRH) is a rare, potentially lethal entity that can arise from a variety of etiologies. We present a case of SRH secondary to hemorrhage from the right inferior adrenal artery in a 22-year-old woman. The patient presented to the emergency room with significant right flank pain, and computed tomography (CT) demonstrated a large, right-sided retroperitoneal hematoma with no identifiable etiology. Renal angiography revealed active extravasation from the right inferior adrenal artery. The patient was definitively treated with endovascular coiling of the ruptured artery, and long term follow up demonstrated resolution of the retroperitoneal hematoma.
Extravasation
Retroperitoneal Hemorrhage
Etiology
Retroperitoneal space
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Anticoagulant drugs are used to reduce the incidence of thromboembolic events in patients at risk. However, minor and major bleeding complications may occur during anticoagulation therapy. Femoral neuropathy secondary to retroperitoneal hematoma is a well known complication of anticoagulant drugs. However, treatment of these patients is still controversial, both conservative and surgical treatments have been advocated. Herein, we report a male patient receiving warfarin for 7 years who developed femoral neuropathy due to retroperitoneal hematoma and was successfully treated with conservative methods. We suggest that conservative treatment and appropriate rehabilitation program should be given to the patients who do not demonstrate any signs of a continued bleeding and any progressive neurological deficits.
Retroperitoneal Hemorrhage
Conservative Treatment
Femoral nerve
Retroperitoneal space
Anticoagulant Therapy
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Spontaneous retroperitoneal hemorrhage is a distinct clinical entity that can present in the absence of specific underlying pathology or trauma and is typically associated with anticoagulation therapy. We report a case of a 74-year-old female patient with a cerebral infarction related to atrial fibrillation who developed a spontaneous lumbar arterial hemorrhage complicating heparin therapy. The diagnosis was suggested by a computed tomography scan and confirmed by angiography. She was treated successfully with transcatheter embolization.
Retroperitoneal Hemorrhage
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Anticoagulant Therapy
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Spontaneous retroperitoneal hematomas developed in two patients on long-term dialysis. In one, a femoral nerve palsy resulted. Recovery was slow, but complete. The second patient had the manifestations of obstructive jaundice. Diagnosis was made surgically, the hematoma was evacuated, and the obstruction was relieved. (JAMA230:1164-1165, 1974)
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Retroperitoneal Hemorrhage
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4 Patients with renal angiomyolipomas are presented. One of them had tuberous sclerosis with synchronous bilateral tumors. All the patients were symptomatic, 2 of them with retroperitoneal hemorrhage. In all patients selective arterial embolization was performed. Permanent control of the symptoms was successful in 2 patients. In 1 patient temporary resolution of the symptoms was observed, and a second embolization was required. Retroperitoneal bleeding in 1 patient continued and nephrectomy was undertaken.
Angiomyolipoma
Retroperitoneal Hemorrhage
Arterial Embolization
Retroperitoneal space
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Abstract Background : Spontaneous retroperitoneal hematoma (SRH) is defined as bleeding in the retroperitoneal space without any triggers such as trauma, invasive procedures, and abdominal aortic aneurysm. Case presentation : A 48-year-old man who experienced sudden abdominal pain, severe hypotension, and decreased hemoglobin (Hb) was diagnosed with SRH. Contrast-enhanced computed tomography (CT) revealed massive left retroperitoneal hematoma; however, neither extravasation nor causative aneurysm was noted. Through conservative management with close monitoring, he was treated and discharged on the 10 th hospital day without any morbidity. Conclusions : SRH treatment comprises conservative management, transcatheter arterial embolization, and surgical intervention. The mortality rate of SRH is so high that the optimal treatment timing needs to be carefully judged based on detailed evaluation and management algorithm with clear criteria.
Retroperitoneal Hemorrhage
Extravasation
Conservative Management
Presentation (obstetrics)
Retroperitoneal space
Arterial Embolization
Case presentation
Conservative Treatment
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Citations (0)
Objective To investigate the value of uterial arterial embolization treatment of postpartum hemorrhage.Methods 14 patients with postpartum hemorrhage failed to the drugs treatment were performed supersellective uterial arterial embolization by Seldinger technique.Results 12 case were successfully embolized through uterial artery,2 cases were embolized by arteria iliaca interna;Bleeding were cessation after the arterial embolization in 12 patients,Subtotal hysterectomy were performed in 2 cases because of incomplete haemostasis;The followup study showed that 12 patients had normal menstrual periods in 3-10 months and no serious complications were found.Conclusion Uterial arterial embolisis is an effective method for postpartum hemorrhage,with the characteristic of fast hemostasis and less complications.
Arterial Embolization
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