Olapoju Oluwatomisin M, Botros Joseph, Damani Bobbie, Tiesenga Frederick
Surgery, Richmond Gabriel University, Kingstown, VCT.
Surgery, St. George's University School of Medicine, True Blue, GRD.
Cureus. 2024 Jun 13;16(6):e62330. doi: 10.7759/cureus.62330. eCollection 2024 Jun.
Hematomas are a common occurrence in clinical practice, often resulting from trauma or underlying bleeding disorders. They can manifest with various symptoms depending on their location and size. While hematomas are typically straightforward to diagnose and manage, specific presentations can pose diagnostic challenges. We present the case of a growing post-traumatic right upper extremity mass in a 67-year-old male on anticoagulant medication, Xarelto (rivaroxaban) 20mg, with no history of bleeding disorders. Differential diagnoses include a benign lipoma or possible soft-tissue malignancy. The mass was surgically excised and sent to pathology, which confirmed it was a hematoma and led to a diagnosis of a chronic expanding hematoma. Ultrasonography, computed tomography, and magnetic resonance imaging are diagnostic modalities that can help distinguish different presentations. Despite the commonality of hematomas in clinical practice, atypical hematomas may also present unique challenges in diagnosis and management due to their varied clinical presentations and locations. This report underlines the importance of understanding hematomas' diverse etiologies, presentations, and imaging characteristics for appropriate treatment and diagnosis.
血肿在临床实践中很常见，通常由创伤或潜在的出血性疾病引起。根据其位置和大小，血肿可表现出各种症状。虽然血肿通常易于诊断和处理，但特定的表现可能会带来诊断挑战。我们报告一例67岁男性在服用抗凝药物拜瑞妥（利伐沙班）20mg的情况下，创伤后右上肢肿块不断增大的病例，该患者无出血性疾病史。鉴别诊断包括良性脂肪瘤或可能的软组织恶性肿瘤。该肿块经手术切除并送病理检查，结果证实为血肿，从而诊断为慢性扩展性血肿。超声、计算机断层扫描和磁共振成像等诊断方法有助于区分不同的表现。尽管血肿在临床实践中很常见，但非典型血肿由于其临床表现和位置各异，在诊断和处理上也可能带来独特的挑战。本报告强调了了解血肿的多种病因、表现和影像学特征对于恰当治疗和诊断的重要性。
