Retroperitoneal Bleeding

Retroperitoneal bleeding happens when the blood vessels or organs in the back part of your abdomen bleed into the space between your abdomen and your back (retroperitoneal space). This space contains:

• Your kidneys.

• The glands that are on top of your kidneys (adrenal glands).

• The tubes that drain urine from your kidneys (ureters).

• The large blood vessel that carries blood to your lower body (aorta).

• Some parts of the system of organs that helps your body digest food (digestive tract).

This condition may be caused by:

• Injury to your abdomen, back, or pelvic area. The pelvic area is the area between your hip bones.

• Procedures in the retroperitoneal space.

Other causes include:

• An abnormal growth of cells (tumor).

• Swelling through a weak wall of a blood vessel (aneurysm). This wall can tear and cause bleeding.

• Fluid-filled sacs (cysts) in the ovaries.

• Bleeding from your spleen.

• Inflammation of the pancreas (pancreatitis).

You are more likely to develop this condition if:

• You take blood thinners (anticoagulants).

• You have a blood clotting disorder.

• You have high blood pressure.

• You are on a machine that cleans your blood (dialysis).

Signs and symptoms are often sudden. They may include:

• Pain in the abdomen, back, groin, or side.

• Pain when pressing on the abdomen, back, or side.

• Bruising in the abdomen, back, or side.

• Pain, numbness, or tingling in your leg.

• Blood in your urine.

• Very low blood pressure.

You may also have other tests, including:

• Blood tests to check for blood loss or low blood counts (anemia).

• Imaging studies, such as:

  • CT scan.

  • Ultrasound.

  • MRI.

  • Angiography. This is when dye is injected into a blood vessel to find the source of the bleeding.

The goal of treatment is to stop the bleeding. Treatment may include:

• Giving you fluids through an IV to get your blood pressure back into a normal range.

• Medicines to undo the effects of blood thinners.

• Giving you blood from someone else (transfusion).

• Watching to see if the bleeding stops on its own.

• Blocking the bleeding with a small plug (embolization). This is done by running a long, thin tube (catheter) through your blood vessel and into the site of the bleeding.

• Doing surgery to find the bleeding and stop it. This may be done using a tool with a camera on the end (laparoscope). It can also be done as an open surgery called a laparotomy.

Activity

• Do not do any activity that takes a lot of effort until your health care provider says that it is safe.

• You may have to avoid lifting. Ask your health care provider how much you can safely lift.

• Rest as told by your health care provider.

General instructions

• Take over-the-counter and prescription medicines only as told by your health care provider.

• Do not use any products that contain nicotine or tobacco. These products include cigarettes, chewing tobacco, and vaping devices, such as e-cigarettes. These can delay healing after surgery. If you need help quitting, ask your health care provider.

• Follow instructions from your health care provider about what you may eat and drink.

• Keep all follow-up visits. Your health care provider will need to make sure your bleeding has stopped. This may require labs or other tests.

These symptoms may be an emergency. Get help right away. Call 911.

• Do not wait to see if the symptoms will go away.

• Do not drive yourself to the hospital.