*32-years-old patient with left flank pain, receiving warfarin.
What is the most likely diagnosis?
Answer
Answer: Spontaneous retroperitoneal hemorrhage
Case Discussion:
Retroperitoneal hemorrhage is most commonly seen following blunt or penetrating trauma, but retroperitoneal hemorrhage can also occur with anticoagulation medication, ruptured abdominal aortic aneurysm, renal tumors, or bleeding diathesis. Rarely, retroperitoneal hemorrhage may be spontaneous. It is associated with a high mortality rate when due to trauma.
Abdominal contrast-enhanced computed tomography scan showing retroperitoneal hematoma on the left side.
References:
1. Daly KP, Ho CP, Persson DL et-al. Traumatic Retroperitoneal Injuries: Review of Multidetector CT Findings. Radiographics. 2008;28 (6): 1571-90.
2. Kawashima A, Sandler CM, Ernst RD et-al. Imaging of nontraumatic hemorrhage of the adrenal gland. Radiographics. 1999;19 (4): 949-63.