Spontaneous retroperitoneal hemorrhage

Spontaneous retroperitoneal hemorrhage (SRH) is a distinctive clinical pathology of retroperitoneal bleeding without a preceding history of trauma.

For a broader discussion, including other etiologies, please refer to the parental article on retroperitoneal hemorrhage

Clinical presentation may be vague and varied:

  • no inciting history
  • no evidence of cutaneous bruising
  • back, lower abdominal or groin pain
  • hemodynamic instability
  • fall in hemoglobin

The pathophysiology and pathogenesis of spontaneous retroperitoneal bleeding are unclear. Many hypotheses have been put forth:

  • diffuse vasculopathy and arteriosclerosis of small retroperitoneal vessels renders them friable and prone to rupture 1
  • anticoagulation induced immune microangiopathy may cause an unrecognised minor trauma in the microcirculation to cause a hemorrhage 2

Spontaneous retroperitoneal hemorrhage is uncommon and is almost exclusively seen in association with:

Based on the clinical scenario and cause, the management can be endovascular repair or open surgery.

Article information

rID: 25596
Synonyms or Alternate Spellings:
  • Spontaneous retroperitoneal hematoma
  • Spontaneous retroperitoneal hemmorhage
  • spontaneous haemmorhage in the retroperitoneusm
  • Spontaneous bleeding in to the retroperitoneum
  • Spontaneous bleed into the retroperitoneum
  • Spontaneous retroperitoneal hemorrhage (SRH)
  • Spontaneous retroperitoneal haematoma

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Cases and figures

  • Case 1: from abdominal aortic aneurysmal rupture
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