From the Guidelines
Retroperitoneal hematoma is primarily caused by trauma, complications from medical procedures, spontaneous bleeding in patients on anticoagulant medications, ruptured abdominal aortic aneurysms, and bleeding from retroperitoneal tumors or cysts, as evident from the most recent study published in 2021 1. The causes of retroperitoneal hematoma can be categorized into several key areas, including:
- Trauma, such as motor vehicle accidents, falls, or direct blows to the abdomen or back
- Complications from medical procedures, like kidney biopsies, lumbar punctures, or vascular interventions
- Spontaneous bleeding in patients on anticoagulant medications, such as warfarin, heparin, or direct oral anticoagulants
- Ruptured abdominal aortic aneurysms
- Bleeding from retroperitoneal tumors or cysts Certain medical conditions that affect blood clotting, such as hemophilia or severe thrombocytopenia, can also increase the risk of developing a retroperitoneal hematoma, as noted in the study published in the Journal of the American College of Radiology 1. The severity of the hematoma depends on the amount of bleeding and how quickly it occurs, with small hematomas potentially resolving on their own with conservative management, while large or rapidly expanding hematomas may require surgical intervention to control bleeding and prevent complications like hypovolemic shock or compression of surrounding structures, as discussed in the study 1. Patients typically present with abdominal or flank pain, and diagnosis is confirmed through imaging studies such as CT scans, which can depict blood, localize areas of bleeding, and evaluate for recent or active extravasation of contrast material, as highlighted in the study published in 2021 1.
From the Research
Causes of Retroperitoneal Hematoma
- Traumatic retroperitoneal hematoma (RPH) may arise from injury to bony structures, major blood vessels, and intestinal or retroperitoneal viscera 2
- Retroperitoneal hemorrhage (RPH) is an infrequent but serious complication of transfemoral percutaneous procedures 3
- Retroperitoneal injury can be caused by penetrating trauma or blunt trauma, and may be associated with progressive shock or major hemorrhage 4
- Traumatic retroperitoneal hematoma can be life-threatening and requires early diagnosis and correct treatment 5
- Retroperitoneal hematoma after blunt trauma can occur, with motor vehicle accidents being a common cause of injury 6
Types of Injuries that Can Cause Retroperitoneal Hematoma
- Fractures of the pelvis 4, 6
- Injuries to major blood vessels 2, 6
- Injuries to intestinal or retroperitoneal viscera 2
- Lumbar spine fractures 4
- Genitourinary, gastrointestinal, pancreatic, or major vascular injuries 4