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Article: Management of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery?

TitleManagement of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery?
Authors
Issue Date2008
PublisherBlackwell 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?
AbstractBackground: 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 Identifierhttp://hdl.handle.net/10722/59955
ISSN
2015 Impact Factor: 2.226
2015 SCImago Journal Rankings: 0.759
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorChan, YCen_HK
dc.contributor.authorMorales, JPen_HK
dc.contributor.authorReidy, JFen_HK
dc.contributor.authorTaylor, PRen_HK
dc.date.accessioned2010-05-31T04:00:50Z-
dc.date.available2010-05-31T04:00:50Z-
dc.date.issued2008en_HK
dc.identifier.citationInternational Journal Of Clinical Practice, 2008, v. 62 n. 10, p. 1604-1613en_HK
dc.identifier.issn1368-5031en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59955-
dc.description.abstractBackground: 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.languageengen_HK
dc.publisherBlackwell Publishing Ltd. The Journal's web site is located at http://www.blackwellpublishing.com/journals/IJCPen_HK
dc.relation.ispartofInternational Journal of Clinical Practiceen_HK
dc.rightsInternational Journal of Clinical Practice. Copyright © Blackwell Publishing Ltd.en_HK
dc.subject.meshAngioscopy - methodsen_HK
dc.subject.meshHematoma - etiology - radiography - surgeryen_HK
dc.subject.meshHemorrhage - radiography - surgeryen_HK
dc.subject.meshHumansen_HK
dc.subject.meshIatrogenic Diseaseen_HK
dc.subject.meshRetroperitoneal Spaceen_HK
dc.subject.meshTomography, X-Ray Computeden_HK
dc.subject.meshVascular Surgical Procedures - methodsen_HK
dc.titleManagement of spontaneous and iatrogenic retroperitoneal haemorrhage: Conservative management, endovascular intervention or open surgery?en_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://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.emailChan, YC: ycchan88@hkucc.hku.hken_HK
dc.identifier.authorityChan, YC=rp00530en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/j.1742-1241.2007.01494.xen_HK
dc.identifier.pmid17949429en_HK
dc.identifier.scopuseid_2-s2.0-51349139436en_HK
dc.identifier.hkuros153565en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-51349139436&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume62en_HK
dc.identifier.issue10en_HK
dc.identifier.spage1604en_HK
dc.identifier.epage1613en_HK
dc.identifier.isiWOS:000259025500021-
dc.publisher.placeUnited Kingdomen_HK
dc.identifier.scopusauthoridChan, YC=27170769400en_HK
dc.identifier.scopusauthoridMorales, JP=8082109300en_HK
dc.identifier.scopusauthoridReidy, JF=7102684353en_HK
dc.identifier.scopusauthoridTaylor, PR=35103559200en_HK
dc.identifier.citeulike3244819-

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