Hemorrhage occurring in retroperitoneal (RP) compartments due to various etiologies
May be misnomer when posterior abdominal wall musculature primarily involved
IMAGING
General Features
Major Causes of Bleeding and Relevant CT Findings
CT Appearance of Blood
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Udare A et al: CT and MR imaging of acute adrenal disorders. Abdom Radiol (NY). 46(1):290-302, 2021
Baekgaard JS et al: Spontaneous retroperitoneal and rectus sheath hemorrhage-Management, risk factors and outcomes. World J Surg. 43(8):1890-7, 2019
Dolapsakis C et al: Spontaneous retroperitoneal hemorrhage. J Emerg Med. 56(6):713-4, 2019
Chung R et al: Clinics in diagnostic imaging (178). Wünderlich syndrome and pseudoaneurysm. Singapore Med J. 58(6):289-93, 2017
Kasotakis G: Retroperitoneal and rectus sheath hematomas. Surg Clin North Am. 94(1):71-6, 2014
Goenka AH et al: Imaging of the retroperitoneum. Radiol Clin North Am. 50(2):333-55, vii, 2012
Tonolini M et al: Hemorrhagic complications of anticoagulant therapy: role of multidetector computed tomography and spectrum of imaging findings from head to toe. Curr Probl Diagn Radiol. 41(6):233-47, 2012
Furlan A et al: Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. AJR Am J Roentgenol. 193(4):1077-87, 2009
Chan YC et al: Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract. 62(10):1604-13, 2008
Rose AJ et al: Warfarin for atrial fibrillation in community-based practise. J Thromb Haemost. 6(10):1647-54, 2008
Federle MP et al: CT criteria for differentiating abdominal hemorrhage: anticoagulation or aortic aneurysm rupture? AJR Am J Roentgenol. 188(5):1324-30, 2007
Rakita D et al: Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. Radiographics. 27(2):497-507, 2007
Nunes JO et al: Abdominal imaging features of HELLP syndrome: a 10-year retrospective review. AJR Am J Roentgenol. 185(5):1205-10, 2005
Willmann JK et al: Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma. AJR Am J Roentgenol. 179(2):437-44, 2002
Harris AC et al: CT findings in blunt renal trauma. Radiographics. 21 Spec No:S201-14, 2001
Lindner A et al: Images in clinical medicine. Retroperitoneal hemorrhage. N Engl J Med. 344(5):348, 2001
Casillas VJ et al: Imaging of nontraumatic hemorrhagic hepatic lesions. Radiographics. 20(2):367-78, 2000
Amano T et al: Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma. Int J Urol. 6(11):585-8, 1999
Patten RM et al: Traumatic laceration of the liver limited to the bare area: CT findings in 25 patients. AJR Am J Roentgenol. 160(5):1019-22, 1993
Trerotola SO et al: Bleeding complications of femoral catheterization: CT evaluation. Radiology. 174(1):37-40, 1990
Orwig D et al: Localized clotted blood as evidence of visceral trauma on CT: the sentinel clot sign. AJR Am J Roentgenol. 153(4):747-9, 1989
Wilms G et al: Embolization of iatrogenic pelvic and retroperitoneal hemorrhage. J Belge Radiol. 72(4):279-82, 1989
Einarsson GV: Spontaneous retroperitoneal hemorrhage as first presentation of carcinoma of the kidney. A case report. Scand J Urol Nephrol. 20(3):235-6, 1986
Illescas FF et al: CT evaluation of retroperitoneal hemorrhage associated with femoral arteriography. AJR Am J Roentgenol. 146(6):1289-92, 1986
Rosen A et al: CT diagnosis of ruptured abdominal aortic aneurysm. AJR Am J Roentgenol. 143(2):265-8, 1984
Federle MP: Computed tomography of blunt abdominal trauma. Radiol Clin North Am. 21(3):461-75, 1983
Samuelsson L et al: Ruptured aneurysm of the internal iliac artery. J Comput Assist Tomogr. 6(4):842-4, 1982
Amendola MA et al: Evaluation of retroperitoneal hemorrhage by computed tomography before and after translumbar aortography. Radiology. 133(2):401-4, 1979
Cisternino SJ et al: Diagnosis of retroperitoneal hemorrhage by serial computed tomography. J Comput Assist Tomogr. 3(5):686-8, 1979
Sagel SS et al: Detection of retroperitoneal hemorrhage by computed tomography. AJR Am J Roentgenol. 129(3):403-7, 1977
Stephens DH et al: Computed tomography of the retroperitoneal space. Radiol Clin North Am. 15(3):377-90, 1977
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KEY FACTS
Terminology
Imaging
Top Differential Diagnoses
Diagnostic Checklist
TERMINOLOGY
Definitions
Hemorrhage occurring in retroperitoneal (RP) compartments due to various etiologies
May be misnomer when posterior abdominal wall musculature primarily involved
IMAGING
General Features
Major Causes of Bleeding and Relevant CT Findings
CT Appearance of Blood
MR Findings
Ultrasonographic Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Image Interpretation Pearls
Selected References
Udare A et al: CT and MR imaging of acute adrenal disorders. Abdom Radiol (NY). 46(1):290-302, 2021
Baekgaard JS et al: Spontaneous retroperitoneal and rectus sheath hemorrhage-Management, risk factors and outcomes. World J Surg. 43(8):1890-7, 2019
Dolapsakis C et al: Spontaneous retroperitoneal hemorrhage. J Emerg Med. 56(6):713-4, 2019
Chung R et al: Clinics in diagnostic imaging (178). Wünderlich syndrome and pseudoaneurysm. Singapore Med J. 58(6):289-93, 2017
Kasotakis G: Retroperitoneal and rectus sheath hematomas. Surg Clin North Am. 94(1):71-6, 2014
Goenka AH et al: Imaging of the retroperitoneum. Radiol Clin North Am. 50(2):333-55, vii, 2012
Tonolini M et al: Hemorrhagic complications of anticoagulant therapy: role of multidetector computed tomography and spectrum of imaging findings from head to toe. Curr Probl Diagn Radiol. 41(6):233-47, 2012
Furlan A et al: Spontaneous abdominal hemorrhage: causes, CT findings, and clinical implications. AJR Am J Roentgenol. 193(4):1077-87, 2009
Chan YC et al: Management of spontaneous and iatrogenic retroperitoneal haemorrhage: conservative management, endovascular intervention or open surgery? Int J Clin Pract. 62(10):1604-13, 2008
Rose AJ et al: Warfarin for atrial fibrillation in community-based practise. J Thromb Haemost. 6(10):1647-54, 2008
Federle MP et al: CT criteria for differentiating abdominal hemorrhage: anticoagulation or aortic aneurysm rupture? AJR Am J Roentgenol. 188(5):1324-30, 2007
Rakita D et al: Spectrum of CT findings in rupture and impending rupture of abdominal aortic aneurysms. Radiographics. 27(2):497-507, 2007
Nunes JO et al: Abdominal imaging features of HELLP syndrome: a 10-year retrospective review. AJR Am J Roentgenol. 185(5):1205-10, 2005
Willmann JK et al: Multidetector CT: detection of active hemorrhage in patients with blunt abdominal trauma. AJR Am J Roentgenol. 179(2):437-44, 2002
Harris AC et al: CT findings in blunt renal trauma. Radiographics. 21 Spec No:S201-14, 2001
Lindner A et al: Images in clinical medicine. Retroperitoneal hemorrhage. N Engl J Med. 344(5):348, 2001
Casillas VJ et al: Imaging of nontraumatic hemorrhagic hepatic lesions. Radiographics. 20(2):367-78, 2000
Amano T et al: Retroperitoneal hemorrhage due to spontaneous rupture of adrenal myelolipoma. Int J Urol. 6(11):585-8, 1999
Patten RM et al: Traumatic laceration of the liver limited to the bare area: CT findings in 25 patients. AJR Am J Roentgenol. 160(5):1019-22, 1993
Trerotola SO et al: Bleeding complications of femoral catheterization: CT evaluation. Radiology. 174(1):37-40, 1990
Orwig D et al: Localized clotted blood as evidence of visceral trauma on CT: the sentinel clot sign. AJR Am J Roentgenol. 153(4):747-9, 1989
Wilms G et al: Embolization of iatrogenic pelvic and retroperitoneal hemorrhage. J Belge Radiol. 72(4):279-82, 1989
Einarsson GV: Spontaneous retroperitoneal hemorrhage as first presentation of carcinoma of the kidney. A case report. Scand J Urol Nephrol. 20(3):235-6, 1986
Illescas FF et al: CT evaluation of retroperitoneal hemorrhage associated with femoral arteriography. AJR Am J Roentgenol. 146(6):1289-92, 1986
Rosen A et al: CT diagnosis of ruptured abdominal aortic aneurysm. AJR Am J Roentgenol. 143(2):265-8, 1984
Federle MP: Computed tomography of blunt abdominal trauma. Radiol Clin North Am. 21(3):461-75, 1983
Samuelsson L et al: Ruptured aneurysm of the internal iliac artery. J Comput Assist Tomogr. 6(4):842-4, 1982
Amendola MA et al: Evaluation of retroperitoneal hemorrhage by computed tomography before and after translumbar aortography. Radiology. 133(2):401-4, 1979
Cisternino SJ et al: Diagnosis of retroperitoneal hemorrhage by serial computed tomography. J Comput Assist Tomogr. 3(5):686-8, 1979
Sagel SS et al: Detection of retroperitoneal hemorrhage by computed tomography. AJR Am J Roentgenol. 129(3):403-7, 1977
Stephens DH et al: Computed tomography of the retroperitoneal space. Radiol Clin North Am. 15(3):377-90, 1977
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