Retroperitoneal hemorrhage: Difference between revisions
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*May present with abdominal, flank or back pain | *May present with abdominal, flank or back pain | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Abdominal trauma DDX}} | {{Abdominal trauma DDX}} | ||
Revision as of 04:32, 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
Abdominal Trauma
- Abdominal compartment syndrome
- Diaphragmatic trauma
- Duodenal hematoma
- Genitourinary trauma
- Liver trauma
- Pelvic fractures
- Retroperitoneal hemorrhage
- Renal trauma
- Splenic trauma
- Trauma in pregnancy
- Ureter trauma
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