Non-traumatic spontaneous retroperitoneal bleeding: treated by interventional radiology

Authors

  • Ismael Juárez N. Department of Interventional Radiology, General Hospital Dr. Manuel Gea González, Mexico City, México
  • Gerardo M. Perdigón C. Department of Interventional Radiology, General Hospital Dr. Manuel Gea González, Mexico City, México
  • Luis Angel Fernández C. Department of Interventional Radiology, General Hospital Dr. Manuel Gea González, Mexico City, México
  • Denny M. Achicanoy P. Department of Interventional Radiology, General Hospital Dr. Manuel Gea González, Mexico City, México

DOI:

https://doi.org/10.18203/2349-2902.isj20241747

Keywords:

Hemorrhage, Retroperitoneum, Spontaneous

Abstract

Spontaneous retroperitoneal hemorrhage is defined as bleeding into the retroperitoneal space. It is a rare condition classified into traumatic and non-traumatic categories. The underlying causes are multifactorial. Hemorrhage from the lumbar arteries is generally the result of high-speed trauma or spinal instrumentation. Clinical manifestations vary primarily depending on the amount of bleeding. Computed tomography (CT) is the diagnostic modality of choice, helping to identify the presence, location, and guide therapy. Treatment options include conservative management, embolization, and/or surgery. A case is reported here that was diagnosed and treated by interventional radiology at general hospital Dr. Manuel Gea González. A GE revolution 64-slice abdominal CT with intravenous contrast (Ultravist 350) was performed, followed by endovascular treatment with microparticles (300-500 μm). This is a rare etiology documented in the literature. A case is reported here that was diagnosed and treated by interventional radiology at general hospital Dr. Manuel Gea González. A GE revolution 64-slice abdominal CT with intravenous contrast (Ultravist 350) was performed, followed by endovascular treatment with microparticles (300-500 μm). This is a rare etiology documented in the literature. It is a rare condition with high morbidity and mortality rates. First-line treatment is through interventional radiology.

References

Mondie C, Maguire NJ, Rentea RM. Retroperitoneal hematoma. StatPearls - NCBI Bookshelf. 2023.

Abe T, Kai M, Miyoshi O, Nagaie T. Idiopathic retroperitoneal hematoma. Case Rep Gastroenterol. 2010;4(3):318-22.

Nandy K, Patel M, Deshpande A. A rare case of spontaneous massive retroperitoneal hemorrhage due to idiopathic lumbar artery bleed. J Emergencies, Trauma Shock. 2018;11(3):238.

Farrelly C, Fidelman N, Durack JC, Hagiwara E, Kerlan RK. Transcatheter Arterial Embolization of Spontaneous Life-Threatening Extraperitoneal Hemorrhage. J Vascular Interventional Radiol. 2011;22(10):1396-402.

Kim JY, Lee SA, Hwang JJ, Park JB, Park SW, Kim YH, et al. Spontaneous lumbar artery rupture and massive retroperitoneal hematoma, successfully treated with arteriographic embolization. Pak J Med Sci. 2019;35(2):1.

Silipigni S, Ascenti V, Carrafiello G. How to Manage Spontaneous Retroperitoneal Haemorrhage. Cardiovascular Radiol Cardiovascular Interventional Radiol. 2023;46(4):496-7.

Lukies M, Gipson J, Tan SY, Clements W. Spontaneous Retroperitoneal Haemorrhage: Efficacy of Conservative Management and Embolisation. Cardiovascular Interventional Radiol. 2023;46(4):488-95.

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Published

2024-06-27

Issue

Section

Case Reports