Bruynseraede Ruben, Verelst Sandra, Robben Elise, Bielen Didier
UZ Leuven, Leuven. Afd. Spoedgevallendienst.
Contact: Ruben Bruynseraede (
Ned Tijdschr Geneeskd. 2022 Jul 28;166:D6941.
An ilio-psoas hematoma is a spontaneous or traumatic retroperitoneal hemorrhage in the ilio-psoas muscle. It is an uncommon condition, occurring in patients with bleeding disorders or patients on anticoagulant therapy. It has a high mortality and presents itself with non-specific symptoms like pain in de lower back, hip or upper leg.
We present the case of a 70-year-old women, on anticoagulant therapy, presenting with atraumatic pain in de left hip. On clinical exam she complained of pain with active hip flexion and passive hip extension. On CT angiography an iliac hematoma was visible on the left side with an arterial component. She underwent an urgent pelvic arterial embolization.
Timely recognition and treatment of an iliopsoas hematoma can reduce mortality and morbidity. In elderly patients on anticoagulant therapy or with underlying bleeding disorders, this entity should always be considered in unexplained lumbar or hip pain.
髂腰肌血肿是髂腰肌内的自发性或创伤性腹膜后出血。这是一种罕见病症，见于患有出血性疾病的患者或接受抗凝治疗的患者。其死亡率高，表现为非特异性症状，如下背部、髋部或大腿上部疼痛。
我们报告一例70岁女性患者，正在接受抗凝治疗，出现左髋部非创伤性疼痛。临床检查时，她主诉主动屈髋和被动伸髋时疼痛。CT血管造影显示左侧有髂部血肿且伴有动脉成分。她接受了紧急盆腔动脉栓塞术。
及时识别和治疗髂腰肌血肿可降低死亡率和发病率。对于接受抗凝治疗或患有潜在出血性疾病的老年患者，不明原因的腰部或髋部疼痛时应始终考虑到这一病症。
