Nine patients with retroperitoneal hemorrhage are reported. One hemorrhage occurred after an appendectomy, another after a vaginal hysterectomy, and seven as a result of a ruptured abdominal aortic aneurysm.

Retroperitoneal hemorrhage may be classified into hemorrhage due to nontraumatic and traumatic causes. The signs and symptoms are quite similar in both groups but may vary with the underlying cause of the hemorrhage.

The treatment of the retroperitoneal hemorrhage will depend upon the etiology of the condition.

At the onset of the hemorrhage there is an abdominal syndrome simulating a generalized peritonitis and is due to a reflex, most likely from an irritation of the sympathetic and parasympathetic nervous systems.

After this acute stage, a paralytic ileus usually develops. The ileus may occur from twenty-four hours to five days after the onset of the hemorrhage. It is probably due to a paralysis of the sympathetic and parasympathetic systems, rather than a reflex irritation of the splanchnic system.

The prognosis in patients with retroperitoneal hemorrhage will vary and depend entirely upon the etiology of the condition.