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March 25, 1974

Massive Retroperitoneal Hemorrhage With Unusual Presentation

Author Affiliations

From New England Medical Center Hospitals, Boston.

JAMA. 1974;227(12):1422. doi:10.1001/jama.1974.03230250046033

RETROPERITONEAL hemorrhage after blunt trauma, presenting uniquely as a strangulated inguinal hernia, has been reported.1 A second case with similar presentation, but of nontraumatic origin, is described here.

Report of a Case  A 63-year-old man was admitted to the emergency room, complaining of acute pain in the left groin and of left-lower-quadrant "intestinal" pain. The pain, of sudden onset, was sharp, continuous, and without radiation. Also noted was an increasingly painful, tender mass in the left groin. The patient felt weak and dizzy, but he showed no other specific symptoms.He gave an eight-year history of treated hypertension (most recent blood pressure, 180/110 mm Hg), and of hospitalization for acute myocardial infarction six months before his present admission. His recovery was satisfactory, but angina pectoris had appeared during the previous three months.On arrival, his blood pressure was 104/76 mm Hg. Shortly thereafter, a syncopal episode occurred, lasting 15