To determine if spontaneous retroperitoneal hematomas can potentially arise from an arterial source. Current imaging techniques focus on noncontrast CT scans. CT angiography may be performed in addition to determine if active arterial extravasation is present in which a more aggressive approach to management would be undertaken.
The retroperitoneal space includes many organs and vessels with the potential to bleed. It is assumed that spontaneous RP hematomas are venous in origin due to coaguability states and other factors. Noncontrast CT is the current imaging standard. CT angiography may be performed for suspected active bleeding. Contraindications may include renal dysfuntion and severe contrast allergy. If active arterial bleeding is demonstrated, the patient may qualify for intervention such as embolization.
Spontaneous retroperitoneal hematomas may be arterial, rather than strictly venous, in origin. CT angiography can be performed if a retroperitoneal hematoma is detected on noncontrast CT to determine if active extravasation of contrast is demonstrated. This may change the management for the patient as they may qualify for more aggressive treatments such as embolization.
Yhu, S,
Friedman, B,
Lobko, I,
Spontaneous Retroperitoneal Hematomas: Use of CT Angiography to Differentiate Arterial vs Venous Source of Bleeding. Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL.
http://archive.rsna.org/2007/5011749.html
