PMC3806160_01
On admission, computed tomography angiogram (CTA) of the abdominal arteries without the use of intravenous contrast revealed large hyperdense retroperitoneal hematomas expanding both psoas muscles, left more than right, that extend into the iliopsoas muscles, and right quadriceps femoris musculature.
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Computed tomography angiogram (CTA) of the abdominal arteries without the use of intravenous contrast revealed large bilateral retroperitoneal hematomas that extended inferiorly to the inguinal canal and a right thigh hematoma (Figure 1).
Repeat computed tomography of the abdomen and pelvis demonstrating hematoma stability. Better seen are mixed-aged bilateral retroperitoneal hematomas in the posterior pararenal spaces displacing both kidneys anteriorly with marked mass effect on peritoneal structures.
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fig2
However, after five weeks of therapy, most of which were spent in the intensive care unit, the patient's hemoglobin stabilized at 12.0 g/dL with a PTT of 43.4 s and a factor VIII activity of 23% (Table 2), with hematoma stability seen on repeat computed tomography of the abdomen and pelvis (Figure 2).