title: [Clinical spectrum of patients with spontaneous retroperitoneal hematomas].
abstract: OBJECTIVE
  Spontaneous retroperitoneal hematoma (SRH) is a potentially fatal clinical entity requiring immediate recognition and intervention.
  
  
  METHODS
  The clinical records of 18-year-old and older patients admitted to the University Hospital Marqués de Valdecilla from 2003 to 2013 were reviewed. "Spontaneous" was defined as unrelated to trauma, invasive procedures or bleeding due to aortic aneurysm rupture.
  
  
  RESULTS
  Thirty-four patients with SRH (44% were on anticoagulant drugs). One-third of cases had chronic renal insufficiency. Abdominal pain was the most common symptom both in anticoagulated and non-anticoagulated patients (80% in anticoagulated and 89% in non-anticoagulated patients). About one half of the patients developed shock. A CT scan was the most commonly performed diagnostic test, followed by abdominal ultrasound. Most cases were managed conservatively (80%). More than half of the patients (66%) restarted anticoagulation therapy after the acute event with a mean delay of 19 days (range 2-90 days). None of them suffered a new bleeding episode.
  
  
  CONCLUSIONS
  Restarting the anticoagulation treatment after hematoma resolution seems to be a safe practice. There is an increasing frequency of SRH in non-anticoagulated patients.
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, España.
authors.forename: Amada
authors.initials: A
authors.lastname: Sánchez-González
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, España.
authors.forename: Leyre
authors.initials: L
authors.lastname: Riancho-Zarrabeitia
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, España.
authors.forename: Zaida
authors.initials: Z
authors.lastname: Salmón-González
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, España.
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Riancho
authors.affiliation: Departamento de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Universidad de Cantabria, Instituto de Investigación Sanitaria Marqués de Valdecilla (IDIVAL), Santander, España. Electronic address: mirvdc@humv.es.
authors.forename: Carmen
authors.initials: C
authors.lastname: Valero
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects; D005260:Female; D006406:Hematoma / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D012187:Retroperitoneal Space; D012189:Retrospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Anticoagulación; Anticoagulation; Hematoma; Retroperitoneal