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Large Psoas Hematoma Complicating Anti-coagulant Therapy Poses a Diagnostic and Therapeutic Challenge
Author(s) -
Anthony-Joe Nassour,
Hissein Hagguir,
Noel Mahoungou,
Harouna Seydou,
Florida Adam,
S. Arous,
Leila Azzouzi,
Abdel Nasser Dirghil,
Rachida Habbal
Publication year - 2021
Publication title -
cardiology and angiology: an international journal
Language(s) - English
Resource type - Journals
ISSN - 2347-520X
DOI - 10.9734/ca/2021/v10i430177
Subject(s) - medicine , hematoma , discontinuation , iliopsoas muscle , surgery , radiological weapon , lumbar , conservative management , radiology , bed rest , abscess
Spontaneous psoas haematoma in patients on anti-coagulant therapy is a rare phenomenon. It poses a real diagnostic problem and a real therapeutic challenge. We report the case of a 51 year old patient, under anti-vitamin K (acenocoumarone) following a stenosante and tricuspid mitral plasty who presented with right lumbar pain radiating to the lower limb leading to functional impotence. Clinically, he was hemodynamically stable with a hematoma measuring 88x29 mm and extending to 161 mm. The ultrasound scan showed a large collection at the expense of the lumbar psoas muscle and the CT scan showed a swollen appearance of the right psoas muscle in its iliac portion. Management was conservative: discontinuation of anti-vitamin K, bed rest, antibiotic therapy, and monitoring (clinical, biological and radiological). The ultimate outcome was favourable.

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