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April 1960

Retroperitoneal Hemorrhage Presenting as an Inguinal Mass: Report of Two Cases

Author Affiliations

From the Departments of Surgery and Pathology, Veterans Administration Hospital. Surgical Resident (Dr. Perkoff); Chief, Surgical Service (Dr. Serlin); Assistant Chief, Pathology Service (Dr. Skerrett).

AMA Arch Surg. 1960;80(4):660-664. doi:10.1001/archsurg.1960.01290210128026

The retroperitoneal space is an ill-defined region of the body, more a potential than an actual space, which during early embryologic life is projected through the anterior abdominal wall into the scrotum. This space contains viscera including the pancreas, kidneys, adrenals, and third portion of the duodenum, and through it pass the ureters and great vessels of the trunk and lower extremities. Tumors arising in the retroperitoneal area have been reported growing through the inguinal canal.1 It is therefore plausible that large retroperitoneal collections under pressure may dissect through the internal inguinal ring and present as inguinal or scrotal masses resembling hernias.

Two illustrations of this pathological condition were recently encountered on the Surgical Service of the Veterans Administration Hospital, Philadelphia. The first case was one of an acute hemorrhagic pancreatitis with massive retroperitoneal bleeding. The patient was diagnosed as having had an acute intestinal obstruction secondary to a