Spontaneous Retroperitoneal Hemorrhage with Psoas Hematoma in an Elderly Patient: A Diagnostic and Therapeutic Challenge
Öz
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.
Anahtar Kelimeler
Spontaneous Retroperitoneal Hemorrhage Psoas Hematoma Anticoagulant Therapy Transarterial Embolization
Etik Beyan
ethics committee certificate not required
Destekleyen Kurum
none
Proje Numarası
none
Teşekkür
none
Kaynakça
- 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
- 2. A Bastu et al. (2014). Anticoagulants and spontaneous hematomas: A review of clinical cases. Archives of Internal Medicine.
- 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
- 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
- 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
- 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
- 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
Yaşlı Bir Hastada Psoas Hematomu ile Birlikte Spontan Retroperitoneal Hemoraji: Tanısal ve Terapötik Bir Zorluk
Öz
Giriş
Spontan 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.
Sonuç
Antikoagülan 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.
Anahtar Kelimeler
Spontan Retroperitoneal Kanama Psoas Hematomu Antikoagülan Tedavi Transarteryal Embolizasyon
Etik Beyan
etik kurul gerekli değildir
Destekleyen Kurum
yok
Proje Numarası
none
Teşekkür
yok
Kaynakça
- 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
- 2. A Bastu et al. (2014). Anticoagulants and spontaneous hematomas: A review of clinical cases. Archives of Internal Medicine.
- 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
- 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
- 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
- 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
- 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
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Acil Tıp, Geriatri ve Gerontoloji |
| Bölüm | Case Report |
| Yazarlar | |
| Proje Numarası | none |
| Yayımlanma Tarihi | 30 Eylül 2025 |
| Gönderilme Tarihi | 15 Aralık 2024 |
| Kabul Tarihi | 28 Mayıs 2025 |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 16 Sayı: 3 |
