Retroperitoneal hematoma Quiz: Ace Your Exams
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A 42-year-old woman is brought to the emergency department after falling down a flight of stairs. The patient was walking home when she lost balance, fell backward, and slid down a flight of stairs approximately 10 feet in height. The patient is currently experiencing severe pain in the posterior left thorax, abdomen, and flank. Past medical history is notable for hypertension. Temperature is 37.2°C (99.0°F), pulse is 108/min, and blood pressure is 148/89 mmHg. Physical examination shows multiple areas of bruising and skin lacerations on the posterior left thorax, and a large area of bruising located over the left flank region. Abdominal exam is significant for a soft abdomen without tenderness to palpation, rebound, or guarding. Lower extremity pulses are present an equal bilaterally. Hemoglobin is 9.5 g/dL (reference range: 12-16 g/dL). CT imaging demonstrates fluid accumulation in the left retroperitoneal space, as shown below. What is the most likely cause of this patient’s presentation?


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