Treatment approaches for spontaneous retroperitoneal bleeding.

In this study, we investigated critical issues in the diagnosis and treatment of spontaneous retroperitoneal bleeding. The medical records of 16 patients who were admitted to the emergency department and were diagnosed as having spontaneous retroperitoneal bleeding were reviewed retrospectively. Retroperitoneal bleeding was diagnosed by intravenous contrast-enhanced computed tomography in 8 men and 8 women (median age, 70.5 years; mean hemoglobin level, 7.4 +/- 1.3 mg/dl). Thirteen patients (81%) received conservative treatment. Bleeding was controlled by therapeutic angiographic intervention in two patients (12%) and by surgery in one patient (6%). Two patients (12%) died. Clinicians should suspect retroperitoneal bleeding in anemic patients who are admitted to an emergency department. If active bleeding is detected, interventional radiologic methods should be used as the initial treatment, and surgery can be performed if conservative and interventional radiologic methods fail.