Retroperitoneal hemorrhage: Difference between revisions
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==Background== | ==Background== | ||
*bleeding into retroperitoneal space | *bleeding into retroperitoneal space | ||
*difficult to diagnose given poor sensitivity of physical exam findings (Cullens, Grey-Turners) | *difficult to diagnose given poor sensitivity of physical exam findings (Cullens, Grey-Turners) | ||
*FAST and DPL do not evaluate retroperitoneal space | *FAST and DPL do not evaluate retroperitoneal space | ||
*can accumulate 4L blood before tamponade | *can accumulate 4L blood before tamponade | ||
*must have high clinical suspicion to make diagnosis | *must have high clinical suspicion to make diagnosis | ||
===Etiologies=== | |||
*Trauma | |||
*Leaking/ruptured [[AAA]] | |||
*Iatrogenic (colonoscopy, cardiac catheterization) | |||
*Spontaneous ([[coagulopathy]]) | |||
*Hemorrhagic [[pancreatitis]] | |||
==Clinical Features== | ==Clinical Features== | ||
*May present with abdominal, flank or back pain | *May present with abdominal, flank or back pain | ||
Revision as of 04:25, 6 June 2015
Background
- bleeding into retroperitoneal space
- difficult to diagnose given poor sensitivity of physical exam findings (Cullens, Grey-Turners)
- FAST and DPL do not evaluate retroperitoneal space
- can accumulate 4L blood before tamponade
- must have high clinical suspicion to make diagnosis
Etiologies
- Trauma
- Leaking/ruptured AAA
- Iatrogenic (colonoscopy, cardiac catheterization)
- Spontaneous (coagulopathy)
- Hemorrhagic pancreatitis
Clinical Features
- May present with abdominal, flank or back pain
Differential Diagnosis
Diagnosis
- CT scan abdomen/pelvis
Management
- Address A, B, C's
- Resuscitation with blood products
- Reverse coagulopathy
- Treat underlying etiology
Disposition
- ICU
See Also
External Links
References
- CURRENT Diagnosis and Treatment Emergency Medicine 7th ed