Psoas muscle hematoma presenting as painful monoplegia

Abstract

I present here a case of psoas (retroperitoneal) hematoma; which is a rare, but potentially life-threatening acute condition, with a 30-day mortality of 10% from bleeding in the retroperitoneal space without associated trauma or iatrogenic intervention. A 59-year-old man who was on long-term anticoagulation for his atrial fibrillation presented to our facility with worsening pain in the left groin and being unable to move the left leg and walk. Computed tomography showed a large left psoas hematoma. He was treated conservatively which included reversal of his anticoagulation state. This case highlights the need for early diagnosis of psoas hematoma by computed tomography scan of the abdomen and pelvis to promptly initiate treatment to improve functional outcome.