Non-penetrating traumatic psoas muscle hematoma presenting with gross hematuria: a case report

Abstract

Psoas muscle hematoma is defined as a spontaneous or traumatic retroperitoneal collection of blood involving the psoas muscle. Early symptoms of an iliopsoas hematoma include lower abdominal or severe groin pain. Although psoas hematoma is a known complication of coagulopathy, psoas hematoma caused by non-penetrating trauma is the subject of only scattered reports and its significance has not been well described in the literature, so the aim of this study was to report a case of blunt traumatic psoas hematoma with the fracture of vertebral transverse process with the presentation of gross hematuria. A 65-year-old Iranian man slipped backward to the ground, and the patient complaint of gross hematuria and difficulty in walking. There was severe left costo-vertebral angle (CVA) tenderness, and mild groin tenderness, and the lower back area was painful, and he had some pain with the flexion of the vertebral column, and there was tenderness on lumbar spine, but there was no tingling, paresthesia, and weakness in left lower extremity. Hip flexion was 3/5 in the left lower. We used some diagnostic modalities as x-ray radiography, ultrasonography, computed tomography (CT) scan with intravenous (IV) contrast, CT cystography, and intravenous pyelogram (IVP) IVP to differentiate the diagnoses and also find skeletal and other organ injuries associated with this kind of injury. We can conclude that post-traumatic psoas hematoma is a rare condition. The diagnostic modality of choice is CT scan which allows rapid identification and measurement of the hematoma. The lesion usually treated with non-operative conservative management.

Road Traffic Accident Traumatic Vehicle Seat Belt Abdominal Wall Hernia

“…After using a CT scan in this situation, the diagnosis of iliopsoas injuries was mostly established. Before the advent of CT scans, the diagnosis was challenging and required an autopsy or surgery [10].…”

Intramuscular Hematomas in Patients Receiving Prophylaxis or Anticoagulant Treatment after Spinal Cord Injury (SCI)—A Rare Complication: Description of Seven Cases and a Literature Analysis

“…The most commonly affected area is the rectus sheath [ 15 , 16 , 17 , 18 ]. Hematomas within the lumbar and iliac muscles have also been described, which may lead to hemodynamic instability and could potentially be fatal [ 19 , 20 ]. SMHs can be divided into small ones, which are clinically insignificant and most often remain contained in the fascia—mainly treated conservatively—and large ones that can cause hemodynamic instability and may be life threatening.…”

“…The main symptoms of SMH are pain at the site of SMH formation, emphasized by numerous authors, and, depending on the location and size of the swelling in a given area, a decrease in hemoglobin and hemodynamic instability [ 18 , 19 , 20 ]. Intramuscular hematomas in patients after SCI are rarely reported.…”

Perdarahan Iliopsoas Pada Pasien Covid-19 Dalam Terapi Antikoagulan

“…Insidens IPH secara umum hanya 0,1%, dan pada populasi usia lanjut sekitar 0,6%. Melihat penggunaan antikoagulan yang masif pada hampir semua pasien Covid-19, serta patogenesis covid-19 yang merusak vaskular dan sistem koagulasi, 1,13 kemungkinan insidens perdarahan, termasuk IPH, pada kasus covid-19 dapat lebih tinggi daripada insidens populasi umum. Meskipun risiko thrombosis pada covid-19 meningkat dan berkorelasi dengan mortalitas, kita perlu meningkatkan kewaspadaan terhadap risiko perdarahan covid-19 yang juga sangat berpengaruh terhadap mortalitas pasien.…”