Retroperitoneal Bleeding

Retroperitoneal bleeding is a rare life-threatening problem. It happens when vessels behind the belly (abdomen) begin to bleed. Idiopathic means the cause is not known. Retroperitoneal means the bleeding is taking place behind the peritoneum. The peritoneum is the smooth shiny lining of the abdomen.


The causes of this can include:

  • Bleeding from any organ.

  • Bleeding from a tumor.

  • Trauma. An example is a car accident that:

  • Damages organs in the belly (often the kidneys).

  • Fractures of the pelvis.

  • Bleeding due to clotting disorders.

  • Bleeding from an aneurysm. An aneurysm is a swelling in a vessel from weakening in the wall of the artery. This would be similar to a bulge in a tire. Aneurysms can suddenly rupture and cause massive bleeding. The problems also occur in patients on dialysis. These are some of the known causes; many of the causes are unknown (idiopathic).


  • Swelling in the belly (abdominal mass).

  • Dropping of blood pressure, so there may be a feeling of light headedness or fainting.

  • Nausea and vomiting.


The diagnosis of this problem is made by laboratory work and specialized x-rays. An angiogram may be done which is a specialized x-ray of the vessels to see where the bleeding is coming from.


  • Sometimes the treatment of this may simply involve close observation. This means being admitted to a hospital ICU (Intensive Care Unit) and having the condition watched closely.

  • Often the condition may get better without surgery.

  • If the condition worsens and the condition of the patient becomes unstable, surgery may be necessary to look for possible bleeding areas.