Retroperitoneal Bleeding(Archived)

Excerpt

Retroperitoneal bleeding occurs when blood enters into space immediately behind the posterior reflection of the abdominal peritoneum. The organs of this space include the esophagus, aorta, inferior vena cava, kidneys, ureters, adrenals, rectum, parts of the duodenum, parts of the pancreas, and parts of the colon. Variability in presentation and etiology makes diagnosis quite difficult. One common constellation of symptoms includes abdominal, back, flank, or groin pain, a palpable abdominal mass, and shock.

Management is grounded in rapid diagnosis of bleeding, ongoing resuscitation with frequent reassessments, computed tomography for further diagnostic characterization, angioembolization for ongoing bleeding, and open surgical intervention for unstable patients or those with certain traumatic indications. Retroperitoneal bleeding is a deadly condition with anywhere from 6% to 22% of those affected. Rapid diagnosis and treatment amongst a seasoned acute care personnel team is key to patient survival.