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Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report

INTRODUCTION: Bleeding in the retroperitoneal space is a serious complication. Hypovolemia and shock develop late after losing a large volume of blood. However, point of care ultrasound (POCUS) examinations in adult patients with shock do not include the retroperitoneal space. CASE PRESENTATION: We...

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Autores principales: Bitar, Zouheir Ibrahim, Elshabasy, Ragab Desouky, Mohsen, Mohamed Jaber, Maadarani, Ossama Sajeh, Elzoueiry, Mahmoud Mostafa, Gohar, Mohamed Refaat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857422/
https://www.ncbi.nlm.nih.gov/pubmed/35176581
http://dx.doi.org/10.1016/j.ijscr.2022.106830
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author Bitar, Zouheir Ibrahim
Elshabasy, Ragab Desouky
Mohsen, Mohamed Jaber
Maadarani, Ossama Sajeh
Elzoueiry, Mahmoud Mostafa
Gohar, Mohamed Refaat
author_facet Bitar, Zouheir Ibrahim
Elshabasy, Ragab Desouky
Mohsen, Mohamed Jaber
Maadarani, Ossama Sajeh
Elzoueiry, Mahmoud Mostafa
Gohar, Mohamed Refaat
author_sort Bitar, Zouheir Ibrahim
collection PubMed
description INTRODUCTION: Bleeding in the retroperitoneal space is a serious complication. Hypovolemia and shock develop late after losing a large volume of blood. However, point of care ultrasound (POCUS) examinations in adult patients with shock do not include the retroperitoneal space. CASE PRESENTATION: We present the case of a 74-year-old male with ischemic heart disease on dual antiplatelet. He developed vague abdominal pain and hemoglobin drop without overt bleeding source until he developed shock. Modified POCUS examination that included the retroperitoneal space detected the bleeding source and confirmed later by computerized tomography of the abdomen. The case was managed conservatively. CLINICAL DISCUSSION: The risk factors associated with the formation of spontaneous retroperitoneal hematomas are age above 70 years and dual antiplatelet therapy. The initial integration of point-of-care ultrasound into the assessment of shocked patients leads to an earlier and accurate initial diagnosis with a clear patient care plan. POCUS should include the retroperitoneal space examination in every patient presenting with shock. CONCLUSION: In patients with unexplained hemorrhagic shock, a modified POCUS protocol could help by including an examination of the retroperitoneal space in the assessment.
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spelling pubmed-88574222022-03-02 Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report Bitar, Zouheir Ibrahim Elshabasy, Ragab Desouky Mohsen, Mohamed Jaber Maadarani, Ossama Sajeh Elzoueiry, Mahmoud Mostafa Gohar, Mohamed Refaat Int J Surg Case Rep Case Report INTRODUCTION: Bleeding in the retroperitoneal space is a serious complication. Hypovolemia and shock develop late after losing a large volume of blood. However, point of care ultrasound (POCUS) examinations in adult patients with shock do not include the retroperitoneal space. CASE PRESENTATION: We present the case of a 74-year-old male with ischemic heart disease on dual antiplatelet. He developed vague abdominal pain and hemoglobin drop without overt bleeding source until he developed shock. Modified POCUS examination that included the retroperitoneal space detected the bleeding source and confirmed later by computerized tomography of the abdomen. The case was managed conservatively. CLINICAL DISCUSSION: The risk factors associated with the formation of spontaneous retroperitoneal hematomas are age above 70 years and dual antiplatelet therapy. The initial integration of point-of-care ultrasound into the assessment of shocked patients leads to an earlier and accurate initial diagnosis with a clear patient care plan. POCUS should include the retroperitoneal space examination in every patient presenting with shock. CONCLUSION: In patients with unexplained hemorrhagic shock, a modified POCUS protocol could help by including an examination of the retroperitoneal space in the assessment. Elsevier 2022-02-12 /pmc/articles/PMC8857422/ /pubmed/35176581 http://dx.doi.org/10.1016/j.ijscr.2022.106830 Text en © 2022 The Authors https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Bitar, Zouheir Ibrahim
Elshabasy, Ragab Desouky
Mohsen, Mohamed Jaber
Maadarani, Ossama Sajeh
Elzoueiry, Mahmoud Mostafa
Gohar, Mohamed Refaat
Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title_full Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title_fullStr Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title_full_unstemmed Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title_short Detecting spontaneous retroperitoneal hemorrhage using a modified RUSH protocol: a case report
title_sort detecting spontaneous retroperitoneal hemorrhage using a modified rush protocol: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8857422/
https://www.ncbi.nlm.nih.gov/pubmed/35176581
http://dx.doi.org/10.1016/j.ijscr.2022.106830
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