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Which is not a sign of retroperitoneal hemorrhage?

  1. Back pain

  2. Diminished pulses

  3. Flank ecchymosis

  4. Swelling in the neck

The correct answer is: Swelling in the neck

Swelling in the neck is not associated with retroperitoneal hemorrhage. Retroperitoneal hemorrhage typically occurs due to bleeding into the space behind the peritoneum, which could result from trauma, ruptured blood vessels, or certain medical conditions. Common signs of retroperitoneal hemorrhage include back pain, which occurs due to irritation of nerves or muscles in the back from the accumulation of blood. Diminished pulses can indicate compromised blood flow, and flank ecchymosis, or bruising in the flank area, is a classic sign that blood is pooling in the retroperitoneal space. These symptoms are directly related to the presence of blood outside the vascular system within the retroperitoneal area. In contrast, swelling in the neck is not reflective of this type of hemorrhage and might suggest a different clinical issue, such as edema due to infection or an allergic reaction.