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自发性腹膜后血肿:病例报告。

Spontaneous retroperitoneal hematoma: a case report.

机构信息

Department of Surgery, Teine Keijinkai Hospital, 1-29 Maeda, Sapporo, Hokkaido, 006-8555, Japan.

Department of Medical Radiation Technology, Teine Keijinkai Hospital, Sapporo, Hokkaido, Japan.

出版信息

J Med Case Rep. 2023 Feb 28;17(1):70. doi: 10.1186/s13256-023-03794-4.

DOI:10.1186/s13256-023-03794-4
PMID:36849897
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9972597/
Abstract

BACKGROUND

Spontaneous retroperitoneal hematoma is defined as bleeding in the retroperitoneal space without any triggers such as trauma, invasive procedures, and abdominal aortic aneurysm.

CASE PRESENTATION

A 48-year-old Japanese man who experienced sudden abdominal pain, severe hypotension, and decreased hemoglobin was diagnosed with spontaneous retroperitoneal hematoma. Contrast-enhanced computed tomography revealed massive left retroperitoneal hematoma; however, neither extravasation nor causative aneurysm was noted. Through conservative management with close monitoring, he was treated and discharged on the tenth hospital day without any morbidity.

CONCLUSIONS

Spontaneous retroperitoneal hematoma treatment comprises conservative management, transcatheter arterial embolization, and surgical intervention. The mortality rate of spontaneous retroperitoneal hematoma is so high that the optimal treatment timing needs to be carefully judged on the basis of detailed evaluation, and management algorithm with clear criteria.

摘要

背景

自发性腹膜后血肿是指腹膜后空间内无任何诱因(如创伤、有创操作和腹主动脉瘤)的出血。

病例介绍

一名 48 岁的日本男性突然出现腹痛、严重低血压和血红蛋白降低,被诊断为自发性腹膜后血肿。增强 CT 显示大量左侧腹膜后血肿;然而,未见外渗或导致的动脉瘤。通过密切监测的保守治疗,他在第十天出院,没有任何并发症。

结论

自发性腹膜后血肿的治疗包括保守治疗、经导管动脉栓塞和手术干预。自发性腹膜后血肿的死亡率如此之高,以至于需要根据详细评估仔细判断最佳治疗时机,并制定具有明确标准的管理算法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/51d18a3090c6/13256_2023_3794_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/c24b323a3134/13256_2023_3794_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/a9f448017d41/13256_2023_3794_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/51d18a3090c6/13256_2023_3794_Fig3_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/c24b323a3134/13256_2023_3794_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/a9f448017d41/13256_2023_3794_Fig2_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/44fc/9972597/51d18a3090c6/13256_2023_3794_Fig3_HTML.jpg

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