Spontaneous retroperitoneal hemorrhage may occur if one or more conditions are present.


Vascular defects:

(1) ruptured aneurysm (abdominal aortic, renal, other)

(2) cystic medial necrosis in an artery

(3) segmental arterial mediolysis

(4) immune vasculitis

(5) infectious vasculitis



(1) renal (angiomyolipoma. renal cell carcinoma, transitional cell carcinoma, other)

(2) adrenal (myelolipoma, hemangioma, pheochromocytoma, other)



(1) renal or adrenal tuberculosis

(2) retroperitoneal abscess


Renal disease:

(1) renal infarct

(2) renal calculi

(3) nephritis

(4) rupture of a renal cyst


Other causes:

(1) coagulopathy

(2) anticoagulation therapy


Differential diagnosis: traumatic retroperitoneal hemorrhage, which may be occult or show a delayed presentation


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