Spontaneous Retroperitoneal Hemorrhage

Spontaneous retroperitoneal hemorrhage is an uncommon event and the most frequent event is the rupture of a renal tumor (angiomyolipoma, sarcoma) or an adre nal mass (pheochromocytoma), severe arteriosclerosis, rupture of the renal stenotic artery in von Recklinghausen's disease (Shimizu et al. 1998), or polyarteritis nodosa (Siebels et al. 1998), spontaneous graft rupture, or rupture of the kidney after extracorporal shock wave lithotripsy. Many arguments (whether it be abdominal mechanical pressure, hormonal, or histological ones) suggest that a pregnancy could increase the risk of renal angiomyolipoma rupture. Adrenal pseudocysts may also rupture as a result of blunt injury and cause massive hemorrhage in the retroperitoneum (Favorito et al. 2004).

Rupture of the renal pelvis may result from ureteral tumor, ureteral stone, and stricture of the ureteropelvic junction. The prognosis in spontaneous urinary extravasation is usually good without drainage. Open surgery is seldom indicated. Rupture of renal pelvis during pregnancy is also uncommon. Ruptured renal neoplasms can be a catastrophic clinical presentation.

Acute abdomen and severe colic pain are the common clinical manifestations.

Rupture of the kidney after extracorporal shock wave lithotripsy is an extremely rare and severe complication. Persistent flank pain with macroscopic he-maturia and hemodynamic instability are the main symptoms. Emergency nephrectomy is the subsequent management of the complication (May et al. 2004) (Figs. 15.4.18-15.4.21).

Baby Sleeping

Baby Sleeping

Everything You Need To Know About Baby Sleeping. Your baby is going to be sleeping a lot. During the first few months, your baby will sleep for most of theday. You may not get any real interaction, or reactions other than sleep and crying.

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