Non-traumatic Spontaneous Retroperitoneal Hemorrhage

Abstract

Spontaneous retroperitoneal hemorrhage (SRH) is defined as a retroperitoneal hemorrhage that occurs without proceeding trauma or any underlying pathology. Survival of patients with SRH depends on rapid and accurate diagnosis followed by imperative management, as the bleeding is often insidious and initially unrecognized. Management had mainly consisted of conservative treatment including cessation or reversal of the anticoagulation, fluid resuscitation, and transfusion previously. Although endovascular intervention of transarterial embolization (TAE) for retroperitoneal hemorrhage caused by trauma or iatrogenic injury is an established procedure, TAE for SRH has been controversial due to its unknown pathophysiology and occult diffuse microvascular bleeding. There is therefore no contemporary consensus to suggest when to attempt transarterial embolization in the treatment of SRH.