ACR Appropriateness Criteria® Suspected Retroperitoneal Bleed

Imaging, Expert Panel on Vascular; Verma, Nupur; Steigner, Michael L.; Aghayev, Ayaz; Azene, Ezana M.; Chong, Suzanne T.; Desjardins, Benoı̂t; Khouli, Riham H. El; Harrison, Nick; Hedgire, Sandeep; Kalva, Sanjeeva P.; Lee, Yoo Jin; Mauro, David M.; Mehta, Hiren J.; Meissner, Mark H.; Pillai, Anil K.; Singh, Nimarta; Surányi, Pál; Williamson, Eric E.; Dill, Karin E.

doi:10.1016/j.jacr.2021.09.003

Cited by 2 publications

(3 citation statements)

References 15 publications

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“…CT or CTA of the abdomen is usually considered the appropriate imaging modality in a patient with clinically suspected retroperitoneal bleed [17]. CT can determine the location/s of the bleed and assess for recent or active contrast extravasation, while CTA has a higher sensitivity for detecting active bleeding [7, 8, 11, 14, 17]. In our case, CTA abdomen demonstrated the presence of the retroperitoneal haematoma and evidence of active bleeding.…”

Section: Discussionmentioning

confidence: 71%

“…Although the anatomical details of the retroperitoneal structures may be difficult to evaluate on USG, it has the advantage of being portable which may benefit patients who are too ill to be transported to the radiology department for a CT examination. Magnetic resonance imaging provides excellent soft‐tissue resolution and anatomical detail of the retroperitoneal structures [17] and has been used in addition to USG [9, 12].…”

Section: Discussionmentioning

confidence: 99%

“…Retroperitoneal bleeding can be difficult to assess as the site of bleeding is not easily accessible to physical examination, leading to delay in diagnosis [16]. CT or CTA of the abdomen is usually considered the appropriate imaging modality in a patient with clinically suspected retroperitoneal bleed [17]. CT can determine the location/s of the bleed and assess for recent or active contrast extravasation, while CTA has a higher sensitivity for detecting active bleeding [7,8,11,14,17].…”

Section: Discussionmentioning

confidence: 99%

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Spontaneous retroperitoneal haematoma in severe dengue: A case report

Ab Rahman,

Nik Mazian,

Samad

2023

Tropical Med Int Health

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Dengue is endemic in over 100 countries worldwide, predominantly in the subtropical and tropical regions and the incidence has been increasing globally. Patients with severe dengue may develop massive bleeding, disseminated intravascular coagulopathy and multi‐organ failure. Bleeding may occur in various body cavities and muscles; however, bleeding in the retroperitoneal space is uncommon. We report a case of a 37‐year‐old gentleman who presented with a 4‐day history of fever associated with chills and rigours. On Day 6 of illness, he complained of left lumbar and left iliac fossa pain which was aggravated by movement. A computed tomography angiography scan of the abdomen showed the presence of a retroperitoneal haematoma, left iliopsoas and quadratus lumbarum intramuscular haematoma with active bleeding and left abdominal wall muscles haematoma. His condition gradually improved after multiple blood transfusions and he gained full recovery. Spontaneous retroperitoneal haematoma is an uncommon complication of severe dengue infection. Early diagnosis based on high index of clinical suspicion using appropriate imaging will aid in prompt management of these cases and may prevent deaths.

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Section: Discussionmentioning

confidence: 71%

Section: Discussionmentioning

confidence: 99%