Retroperitoneal hemorrhage
Background
- bleeding into retroperitoneal space
- various etiologies: trauma, leaking/ruptured AAA, iatrogenic (colonoscopy, cardiac catheterization), spontaneous (coagulopathy), hemorrhagic pancreatitis
- 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
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