{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:26:41Z","timestamp":1747182401282,"version":"3.40.5"},"reference-count":15,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Haemorrhagic shock is a life\u2010threatening complication of trauma, but remains a preventable cause of death. Early recognition of retroperitoneal haemorrhage (RPH) is crucial in preventing deleterious outcomes including mortality. Injury to the 9\u201311th intercostal arteries (i.e. arteries of the lower thoracic region) are complicit in RPH. However, the associated injuries, implications and management of such bleeds remain poorly characterised.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We performed a retrospective review of the medical records of patients diagnosed with RPH who presented to our level\u20101 trauma centre (2009\u20132019). We described the associated injuries, management and outcomes relating to RPH of the lower thoracic region (the 9\u201311th intercostal arteries) from this cohort to identify potential predictors and evaluate the impact of early identification and management of non\u2010cavitary bleeds.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Haemorrhage of the lower intercostal arteries (LIA) into the retroperitoneal space is associated with an increased number of posterior lower rib fractures and pneumothorax\/haemothorax. A higher proportion of patients in the LIA group required massive transfusion, angioembolisation or surgical ligation when compared to other causes of RPH.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The present study highlights the importance of injury patterns, particularly posterior lower rib fractures, as predictors for early recognition and management of RPH in the prevention of deleterious patient outcomes. RPH secondary to bleeding of the LIA may require early and aggressive management of haemorrhage through massive transfusion, and angioembolisation or surgical ligation when compared to RPH because of other causes.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1742-6723.14054","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T23:48:21Z","timestamp":1660261701000},"page":"56-61","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Injury patterns, management and outcomes of retroperitoneal haemorrhage caused by lower intercostal arterial bleeding at a level\u20101 trauma centre: A 10\u2010year retrospective review"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3055-6790","authenticated-orcid":false,"given":"Richard N","family":"Schlegel","sequence":"first","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0183-7761","authenticated-orcid":false,"given":"Mark","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Lim","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard M","family":"O'Reilly","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute  Melbourne Victoria Australia"},{"name":"School of Public Health and Preventive Medicine Monash University  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1859-5850","authenticated-orcid":false,"given":"Warren","family":"Clements","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Victoria Australia"},{"name":"Department of Radiology The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University Central Clinical School  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gerard S","family":"Goh","sequence":"additional","affiliation":[{"name":"National Trauma Research Institute  Melbourne Victoria Australia"},{"name":"Department of Radiology The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Department of Surgery Monash University Central Clinical School  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J","family":"Groombridge","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cecil","family":"Johnny","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Emergency and Trauma Centre The Alfred Hospital  Melbourne Victoria Australia"},{"name":"National Trauma Research Institute  Melbourne Victoria Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael P","family":"Noonan","sequence":"additional","affiliation":[{"name":"Trauma Service The Alfred Hospital  Melbourne Victoria Australia"},{"name":"Emergency and Trauma 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arterial embolization of traumatic lumbar artery injury: experience in one institution","volume":"36","author":"Hung S\u2010C","year":"2011","journal-title":"Chin. J. Acad. Radiol."},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-1241.2007.01494.x"},{"key":"e_1_2_8_14_1","first-page":"363","article-title":"Occult sources of bleeding in blunt trauma: a narrative review","volume":"71","author":"Yumoto T","year":"2017","journal-title":"Acta Med. Okayama"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.envint.2018.07.015"},{"key":"e_1_2_8_16_1","first-page":"171","article-title":"Treatment approaches for spontaneous retroperitoneal bleeding","volume":"94","author":"Ekici Y","year":"2009","journal-title":"Int. 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