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- Publisher Website: 10.1111/j.1742-1241.2007.01494.x
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- PMID: 17949429
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Article: Management of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery?
Title | Management of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery? |
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Authors | |
Issue Date | 2008 |
Publisher | Blackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/IJCP |
Citation | International Journal Of Clinical Practice, 2008, v. 62 n. 10, p. 1604-1613 How to Cite? |
Abstract | Background: Retroperitoneal haematoma is a rare clinical entity with variable aetiology, which is increasing in incidence mainly due to complications related to interventional procedures. There is no general consensus as to the best management plan for patients with retroperitoneal haematoma. Methods: A literature review was undertaken using MEDLINE, all relevant papers on retroperitoneal haemorrhage or haematoma were used. Results: The diagnosis is often delayed as symptoms are nonspecific. Retroperitoneal haematoma should be suspected in patients with significant groin, flank, abdominal, back pain or haemodynamic instability following an interventional procedure. Spontaneous haemorrhage usually occurs in patients who are anticoagulated. Multi-slice CT and arteriography are important for diagnosis. Most haemodynamically stable patients can be managed with fluid resuscitation, correction of coagulopathy and blood transfusion. Endovascular treatment involving selective intra-arterial embolisation or the deployment of stent-grafts over the punctured vessel is attaining an increasingly important role. Open repair of retroperitoneal bleeding vessels should be reserved for cases when there is failure of conservative or endovascular measures to control the bleeding. Open repair is also required if endovascular facilities or expertise is unavailable and in cases where the patient is unstable. If treated inappropriately, the mortality of patients with retroperitoneal haematoma remains high. Conclusion: There is a lack of level I evidence for the best management plans for retroperitoneal haematoma, and evidence is based on small cohort series or isolated case reports. Conservative management should only be reserved for patients who are stable. Interventional radiology with intra-arterial embolisation or stent-grafting is the treatment of choice. Open surgery is now rarely required. © 2007 The Authors. |
Persistent Identifier | http://hdl.handle.net/10722/59955 |
ISSN | 2023 Impact Factor: 2.2 2023 SCImago Journal Rankings: 0.634 |
ISI Accession Number ID | |
References |
DC Field | Value | Language |
---|---|---|
dc.contributor.author | Chan, YC | en_HK |
dc.contributor.author | Morales, JP | en_HK |
dc.contributor.author | Reidy, JF | en_HK |
dc.contributor.author | Taylor, PR | en_HK |
dc.date.accessioned | 2010-05-31T04:00:50Z | - |
dc.date.available | 2010-05-31T04:00:50Z | - |
dc.date.issued | 2008 | en_HK |
dc.identifier.citation | International Journal Of Clinical Practice, 2008, v. 62 n. 10, p. 1604-1613 | en_HK |
dc.identifier.issn | 1368-5031 | en_HK |
dc.identifier.uri | http://hdl.handle.net/10722/59955 | - |
dc.description.abstract | Background: Retroperitoneal haematoma is a rare clinical entity with variable aetiology, which is increasing in incidence mainly due to complications related to interventional procedures. There is no general consensus as to the best management plan for patients with retroperitoneal haematoma. Methods: A literature review was undertaken using MEDLINE, all relevant papers on retroperitoneal haemorrhage or haematoma were used. Results: The diagnosis is often delayed as symptoms are nonspecific. Retroperitoneal haematoma should be suspected in patients with significant groin, flank, abdominal, back pain or haemodynamic instability following an interventional procedure. Spontaneous haemorrhage usually occurs in patients who are anticoagulated. Multi-slice CT and arteriography are important for diagnosis. Most haemodynamically stable patients can be managed with fluid resuscitation, correction of coagulopathy and blood transfusion. Endovascular treatment involving selective intra-arterial embolisation or the deployment of stent-grafts over the punctured vessel is attaining an increasingly important role. Open repair of retroperitoneal bleeding vessels should be reserved for cases when there is failure of conservative or endovascular measures to control the bleeding. Open repair is also required if endovascular facilities or expertise is unavailable and in cases where the patient is unstable. If treated inappropriately, the mortality of patients with retroperitoneal haematoma remains high. Conclusion: There is a lack of level I evidence for the best management plans for retroperitoneal haematoma, and evidence is based on small cohort series or isolated case reports. Conservative management should only be reserved for patients who are stable. Interventional radiology with intra-arterial embolisation or stent-grafting is the treatment of choice. Open surgery is now rarely required. © 2007 The Authors. | en_HK |
dc.language | eng | en_HK |
dc.publisher | Blackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/IJCP | en_HK |
dc.relation.ispartof | International Journal of Clinical Practice | en_HK |
dc.rights | International Journal of Clinical Practice. Copyright © Blackwell Publishing Ltd. | en_HK |
dc.subject.mesh | Angioscopy - methods | en_HK |
dc.subject.mesh | Hematoma - etiology - radiography - surgery | en_HK |
dc.subject.mesh | Hemorrhage - radiography - surgery | en_HK |
dc.subject.mesh | Humans | en_HK |
dc.subject.mesh | Iatrogenic Disease | en_HK |
dc.subject.mesh | Retroperitoneal Space | en_HK |
dc.subject.mesh | Tomography, X-Ray Computed | en_HK |
dc.subject.mesh | Vascular Surgical Procedures - methods | en_HK |
dc.title | Management of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery? | en_HK |
dc.type | Article | en_HK |
dc.identifier.openurl | http://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1368-5031&volume=62&issue=10&spage=1604&epage=1613&date=2008&atitle=Management+of+spontaneous+and+iatrogenic+retroperitoneal+haemorrhage:+conservative+management,+endovascular+intervention+or+open+surgery? | en_HK |
dc.identifier.email | Chan, YC: ycchan88@hkucc.hku.hk | en_HK |
dc.identifier.authority | Chan, YC=rp00530 | en_HK |
dc.description.nature | link_to_subscribed_fulltext | - |
dc.identifier.doi | 10.1111/j.1742-1241.2007.01494.x | en_HK |
dc.identifier.pmid | 17949429 | en_HK |
dc.identifier.scopus | eid_2-s2.0-51349139436 | en_HK |
dc.identifier.hkuros | 153565 | en_HK |
dc.relation.references | http://www.scopus.com/mlt/select.url?eid=2-s2.0-51349139436&selection=ref&src=s&origin=recordpage | en_HK |
dc.identifier.volume | 62 | en_HK |
dc.identifier.issue | 10 | en_HK |
dc.identifier.spage | 1604 | en_HK |
dc.identifier.epage | 1613 | en_HK |
dc.identifier.isi | WOS:000259025500021 | - |
dc.publisher.place | United Kingdom | en_HK |
dc.identifier.scopusauthorid | Chan, YC=27170769400 | en_HK |
dc.identifier.scopusauthorid | Morales, JP=8082109300 | en_HK |
dc.identifier.scopusauthorid | Reidy, JF=7102684353 | en_HK |
dc.identifier.scopusauthorid | Taylor, PR=35103559200 | en_HK |
dc.identifier.citeulike | 3244819 | - |
dc.identifier.issnl | 1368-5031 | - |