Ekici Yahya, Aydogan Cem, Yagmurdur Mahmut C, Kirnap Mahir, Harman Ali, Moray Gokhan, Karakayali Hamdi, Haberal Mehmet
Department of General Surgery, Baskent University Faculty of Medicine, Ankara, Turkey.
Int Surg. 2009 Apr-Jun;94(2):171-5.
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.
在本研究中，我们调查了自发性腹膜后出血诊断和治疗中的关键问题。回顾性分析了16例因自发性腹膜后出血入住急诊科患者的病历。通过静脉注射对比增强计算机断层扫描诊断出8名男性和8名女性腹膜后出血（中位年龄70.5岁；平均血红蛋白水平7.4±1.3mg/dl）。13例患者（81%）接受了保守治疗。2例患者（12%）通过治疗性血管造影干预控制了出血，1例患者（6%）通过手术控制了出血。2例患者（12%）死亡。临床医生应怀疑入住急诊科的贫血患者有腹膜后出血。如果检测到活动性出血，应采用介入放射学方法作为初始治疗，若保守治疗和介入放射学方法失败，则可进行手术。
