TY - JOUR T1 - Spontaneous Retroperitoneal Hemorrhage with Psoas Hematoma in an Elderly Patient: A Diagnostic and Therapeutic Challenge TT - Yaşlı Bir Hastada Psoas Hematomu ile Birlikte Spontan Retroperitoneal Hemoraji: Tanısal ve Terapötik Bir Zorluk AU - Eyüboğlu, Kayahan AU - Keskin, Cem PY - 2025 DA - September Y2 - 2025 DO - 10.33706/jemcr.1600787 JF - Journal of Emergency Medicine Case Reports PB - Acil Tıp Uzmanları Derneği WT - DergiPark SN - 2149-9934 SP - 86 EP - 88 VL - 16 IS - 3 LA - en AB - Introduction:Spontaneous retroperitoneal hemorrhage (SRH) is a rare but life-threatening condition, often challenging to diagnose and manage, particularly in elderly patients. Anticoagulant therapy significantly increases the risk of complications such as psoas hematoma.Case Report:A 93-year-old male on anticoagulation therapy presented with dizziness and syncope, leading to the discovery of an 8 cm psoas hematoma via imaging. The patient was treated with blood transfusion, Vitamin K, and interventional radiology, achieving hemostasis without surgical intervention.Conclusion:Early recognition and prompt intervention are crucial for managing SRH in elderly patients on anticoagulants. This case highlights the importance of multidisciplinary approaches and imaging in achieving successful outcomes. KW - Spontaneous Retroperitoneal Hemorrhage KW - Psoas Hematoma KW - Anticoagulant Therapy KW - Transarterial Embolization N2 - GirişSpontan retroperitoneal hemoraji (SRH) nadir görülen ancak yaşamı tehdit eden bir durumdur ve özellikle yaşlı hastalarda teşhis edilmesi ve yönetilmesi genellikle zordur. Antikoagülan tedavi psoas hematomu gibi komplikasyon riskini önemli ölçüde artırır.Vaka Raporu:Antikoagülan tedavisi gören 93 yaşındaki erkek hasta baş dönmesi ve senkop şikâyetleriyle başvurmuş ve yapılan görüntüleme sonucunda 8 cm'lik bir psoas hematomu tespit edilmiştir. Hasta kan transfüzyonu, K vitamini ve girişimsel radyoloji ile tedavi edildi ve cerrahi müdahale olmaksızın hemostaz sağlandı.SonuçAntikoagülan kullanan yaşlı hastalarda SRH'yi yönetmek için erken tanı ve hızlı müdahale çok önemlidir. Bu vaka, başarılı sonuçlara ulaşmada multidisipliner yaklaşımların ve görüntülemenin önemini vurgulamaktadır. CR - 1. Choi, K., & Kwak, J. (2014). Retroperitoneal hematoma due to spontaneous rupture of lumbar artery in patients taking anticoagulant and/or antiplatelet: A retrospective analysis. Journal of the Korean Society of Emergency Medicine. Retrieved from http://www.jksem.org/upload/pdf/18403082.pdf CR - 2. A Bastu et al. (2014). Anticoagulants and spontaneous hematomas: A review of clinical cases. Archives of Internal Medicine. CR - 3. Morino, J., Hirai, K., & Morishita, Y. (2024). Spontaneous lumbar artery rupture presenting with retroperitoneal hematoma and extensive subcutaneous hemorrhage. Oxford Medical Case Reports, 2024(3), 82-83. https://doi.org/10.1093/omcr/omae008 CR - 4. Tiralongo, F., Toscano, S., Mosconi, C. et al. Spontaneous retroperitoneal hematoma treated with transarterial embolization: a systematic review and metanalysis. CVIR Endovasc 7, 50 (2024). https://doi.org/10.1186/s42155-024-00462-6 CR - 5. Sunga, K. L., Bellolio, M. F., Gilmore, R. M., & Cabrera, D. (2012). Spontaneous retroperitoneal hematoma: etiology, characteristics, management, and outcome. The Journal of emergency medicine, 43(2), e157–e161. https://doi.org/10.1016/j.jemermed.2011.06.006 CR - 6. Bouhaddoune, Y., Bilal, M., Mahjouba, H., Skiker, I., El Ouaa, N., & Bazid, Z. (2022). Spontaneous retroperitoneal hematoma induced by vitamin K antagonist therapy: A case report. Radiology Case Reports, 17(2022), 2269-2272. https://doi.org/10.1016/j.radcr.2022.03.099 CR - 7. Ibrahim, W., Mohamed, A., Sheikh, M., Shokr, M., Hassan, A., Weinberger, J., & Afonso, L. C. (2017). Antiplatelet therapy and spontaneous retroperitoneal hematoma: A case report and literature review. American Journal of Case Reports, 18, 85-89. https://doi.org/10.12659/AJCR.901622 UR - https://doi.org/10.33706/jemcr.1600787 L1 - https://dergipark.org.tr/tr/download/article-file/4437387 ER -